Hormonal
Perivascular adipose tissue (PVAT) dysfunction, characterized by reduced adiponectin secretion and increased pro-inflammatory cytokines, directly contributes to hypertension and insulin resistance by losing its anti-contractile effect on blood vessels.
Focus on reducing visceral fat rather than just total body weight. Strategies that promote 'beiging' of adipose tissue (like cold exposure) or reduce inflammation may help improve vascular health and blood pressure, even if overall weight loss is modest. Prioritize metabolic health markers over BMI.
Loss of this PVAT function will lead to an increase in vascular tone and may contribute to development of hypertension and T2D (786).
Why this rating
The paper is a comprehensive review citing numerous human and animal studies, including knockout mouse models demonstrating causal links.
Source
Mechanistic Links Between Obesity, Diabetes, and Blood Pressure: Role of Perivascular Adipose Tissue
Sophie N. Saxton et al. · Physiological Reviews · 2019
DOI 10.1152/physrev.00034.2018
More from this paper
- Adiponectin, secreted by healthy PVAT, acts as a vasodilator by activating AdipoR1 receptors, stimulating AMPK and eNOS to produce nitric oxide, thereby lowering blood pressure and improving insulin sensitivity.Strong
- Visceral adipose tissue (VAT) is strongly associated with insulin resistance, dyslipidemia, and hypertension, independent of subcutaneous fat and BMI, due to its pro-inflammatory secretory profile.Good
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