What is the first line class of antihypertensives recommended for patients with obesity?

The first-line class of antihypertensives recommended for patients with obesity is RAS inhibitors, which include Angiotensin-Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs). This recommendation is based on the effectiveness of RAS inhibitors in addressing hypertension, which is common in individuals with obesity due to various factors such as increased blood volume, higher cardiac output, and other metabolic changes associated with excessive body weight.

RAS inhibitors have several benefits that make them particularly suitable for patients with obesity. They not only help in controlling blood pressure but also have favorable effects on cardiovascular outcomes, renal protection, and the prevention of diabetic nephropathy, which can be significant in obese patients who often have comorbidities such as type 2 diabetes and metabolic syndrome.

Additionally, RAS inhibitors are known to have a favorable side effect profile and are well tolerated, making them good candidates for long-term management in this population. These characteristics, combined with their ability to improve blood pressure control, validate their first-line status in the context of managing hypertension in individuals with obesity.