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Adiponectin and hypertension: a putative link between adipocyte function and atherosclerotic risk?

Journal of Human Hypertension volume 21, pages 1–4 (2007)Cite this article

There is increasing interest on the pathophysiological mechanisms by which obesity confer increased cardiovascular risk. Current attention has focused on the frequent association of centripetal fat accumulation with insulin resistance, high blood pressure (BP) and abnormal glucose and lipid metabolism – the so-called ‘metabolic syndrome’.1 This clinical syndrome (as defined by various definitions) is highly prevalent, with more than one in five adults from the third National Health and Nutrition Survey (NHANES III) in United States and almost 43% of people over the age of 60 years meeting the criteria for the metabolic syndrome.2 That this syndrome is associated with increased cardiovascular risk is well documented and may identify obese individuals at high risk of cardiovascular events.3, 4

Centripetal fat accumulation has been proposed as the etiological driver for this metabolic risk factor clustering, as studies consistently link waist circumference (a surrogate for centripetal visceral fat) with other components of the metabolic syndrome and increased cardiovascular risk. This is reflected in the recent International Diabetes Federation definition of the metabolic syndrome, which emphasizes the central importance of waist circumference.5 However, data from longitudinal studies specifically designed to chart the development and progression of this syndrome are lacking. As such, the cause–effect relationship of obesity and cardiovascular disease is at best inferred rather than established.6 Indeed, a ‘metabolically obese but normal weight’ phenotype is well described, whereas the relationship between obesity and other features of the metabolic syndrome is not absolute.7 In a study of the NHANES III population, the association between obesity (by waist circumference) and cardiovascular disease (myocardial infarction and stroke) was not significant after adjusting for other components of the metabolic syndrome, implying that the cardiovascular risk associated with obesity may be indirectly mediated by other associated risk factors.8

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  1. University Department of Medicine, Haemostasis, Thrombosis and Vascular Biology Unit, City Hospital, Birmingham, UK

    J V Patel, H S Lim, E A Hughes & G Y H Lip

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Correspondence to G Y H Lip.

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Patel, J., Lim, H., Hughes, E. et al. Adiponectin and hypertension: a putative link between adipocyte function and atherosclerotic risk?. J Hum Hypertens 21, 1–4 (2007). https://doi.org/10.1038/sj.jhh.1002078

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