Despite this, interpretation of the literature remains complicated because few data, if any, fully discriminate the contribution of hypertension per se to cardiotoxicity, from the influence of associated comorbidities (including coronary disease, atrial fibrillation, diabetes, renal dysfunction, obesity [10, 29, 31, 32]) and cardiovascular medications (such as ACE inhibitors, mineralocorticoid receptor antagonists and beta-blockers) which may be cardioprotective [33, 34]. This evidence concerns the gene ACE and obesity due to melanocortin 4 receptor deficiency.