The mechanism of the association between obesity and hypertension may be explained by adipose tissue dysfunction characterized by decreased levels of adiponectin, hyperleptinemia, increased infiltration of macrophages, elevated free fatty acid levels, and elevated resistin levels, which leads to the activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system, augmented systemic inflammation and oxidative stress, and chronic vascular inflammation, leading to hypertension68. This evidence concerns the gene REN and obesity due to melanocortin 4 receptor deficiency.