INS and obesity due to melanocortin 4 receptor deficiency: The pathophysiology of hypertension in obesity is associated with various pathophysiological mechanisms, namely with vascular damage as a consequence of inflammation, endothelial dysfunction and oxidative stress, with sympathetic activation due to elevated leptin and insulin levels, with vasoconstriction, sodium and fluid retention through activation of RAAS and with decreased vagal activity [38,39].