REN and obesity due to melanocortin 4 receptor deficiency: Nearly half our sample were post-menopausal at follow-up and it is well known that menopause is strongly associated with increased hypertension risk, likely due to increased activation of the renin-angiotensin system [31], the rapid drop in oestrogen [32,33], obesity and in particular the redistribution of body fat, favouring an increase in abdominal fat [34,35].