Other possible mechanisms to this phenomenon could be that despite obesity being characterized by increased circulating blood volume, systemic vascular resistance and left ventricular mass (which contribute to development of hypertension) obese patients have 1) lower baseline levels of the renin-angiotensin system and attenuated neurohormonal responses to stress; 2) increased nutritional and metabolic reserves; 3) might better tolerate cardio-protective medications because of elevated blood pressures [28, 30]. Here, REN is linked to obesity due to melanocortin 4 receptor deficiency.