Hypertension in Obese Women: Gender-Specific Challenges and Solutions

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Background

Obesity is a global epidemic and currently the second leading cause of preventable death in the United States of America. Worldwide, women have higher obesity rates than men, which is associated with a higher mortality rate for cardiovascular disease, especially hypertension. The Framingham Study indicates that in 78% of men and 65% of women, hypertension is associated with obesity. The increase in visceral adiposity raises the risk of hypertension through different mechanisms like endothelial dysfunction, abnormal sodium reabsorption, and renal function. Furthermore, the physical compression of the kidneys by fat in and around these organs, leads to increased activation of the renin-angiotensin-aldosterone system, an increase in inflammatory/immune mediators, and overactivity of the autonomous nervous system. In general, premenopausal women have a lower prevalence of hypertension than age-matched men. When women reach menopause (around age 45), the prevalence is similar, but after age 55, the prevalence is higher in postmenopausal women. Within this specific group of women, hypertension is even higher after 75 – 80 years of age, where mortality from cardiovascular events is higher than in premenopausal women and age-matched men. This is accompanied by an increase in visceral fat, with a more pronounced deleterious effect from cardiometabolic, inflammatory and immune factors, which can partly explain the higher blood pressure. If there is a gender difference in the pathophysiological mechanisms, it has yet to be investigated adequately.


This Research Topic aims to discuss the intricate relationship between hypertension and obesity in women, emphasizing the underlying factors contributing to this connection. Additionally, it aims to address the disparities in research, diagnosis, and management of hypertension in obese women, promoting the need for gender-specific approaches to tackle this pressing public health concern.


In this Research Topic, we welcome submissions that cover, but are not limited to:

1. Prevalence and Risk Factors: Examine the prevalence of hypertension in obese women, highlighting the impact of age, hormonal changes (such as pregnancy and menopause), and other risk factors specific to women, such as oral contraceptive use.

2. Underlying Causes and Mechanisms: Explore the gender-specific physiological and hormonal mechanisms that contribute to the development and maintenance of hypertension in obese female experimental animal models and women. Discuss the role of estrogens, progesterone, androgens, the renin-angiotensin system, and the impact of endothelial dysfunction.

3. Diagnostic Challenges: Discuss the unique challenges faced in diagnosing hypertension in obese women, including the potential influence of white coat syndrome, masked hypertension, and the importance of ambulatory blood pressure monitoring.

4. Treatment Approaches: Evaluate the efficacy of current antihypertensive medications in obese women and discuss the need for tailored treatment plans. Highlight the potential impact of lifestyle modifications, including exercise, dietary changes, stress management, and weight management, in managing hypertension in obese women.

5. Pregnancy-Induced Hypertension in obese women: Focus on the specific challenges hypertension poses during pregnancy, including preeclampsia and gestational hypertension. Discuss the short-term and long-term health implications for the mother and the child.

6. Awareness and Education: Emphasize the need for increased awareness and education regarding hypertension in obese women. Propose strategies for healthcare professionals to enhance screening, prevention, and management of hypertension in female patients.


The Editors welcome the following article types: Clinical Trial, Editorial, General Commentary, Mini Review, Opinion, Original Research, Perspective, Review, Study Protocol, and Systematic Review.

Keywords: obesity hypertension, sex/gender-specific, pregnancy-induced hypertension, obese women's cardiovascular health

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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