REN and obesity due to melanocortin 4 receptor deficiency: The pathophysiology of hypertension has yet to be fully elucidated, however proposed risk factors [4,5] include a high salt diet [6], insulin resistance [7], obesity [8,9,10], genetic factors [11], increased sympathetic nervous system (SNS) activity [12], renin-angiotensin system activation [13], and endothelial dysfunction [14].