Increased BMI is associated with higher body fluid volume, peripheral resistance (such as hyperinsulinemia, cell membrane changes, and renin-angiotensin changes-factors that influences functional narrowing and structural hypertrophy), and cardiac output.34 Increased BMI is also related to increased visceral fat, leading to increased leptin and insulin resistance, poor lipid profiles, and increased development of atherosclerosis and chronic renal failure.35 This evidence concerns the gene REN and hyperinsulinism.