When Sweet Turns Salty

SEE PAGE 804 O ne of the most challenging aspects of obesity is its link to “metabolic syndrome,” when abdominal obesity is accompanied by high fasting blood glucose, low levels of high-density lipoprotein cholesterol, high levels of triglycerides, and elevated blood pressure. With rising obesity rates, metabolic syndrome is likely to become more common in the years ahead (1). Although progress has been made in identifying this syndrome’s individual components, their interplay across several organ systems is not well understood; that is, the near-linear relationship between body mass index and blood pressure. Obesity is often recognized as a predictor of treatment-resistant hypertension (2). One of the main endocrine pathways that has been implicated involves natriuretic peptides (3). Natriuretic peptides exert their antihypertensive effects predominantly by inducing natriuresis but have additional effects beyond blood pressure regulation. For example, an antihypertrophic effect, independent of blood pressure, was observed in