Treatment of chronic respiratory diseases in obese people
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* Luca Mascitelli
* Francesca Pezzetta

*   © 2007 Canadian Medical Association or its licensors

Magali Poulain and colleagues do not appear to have considered the action of the renin–angiotensin system in their review of the effect of obesity on chronic respiratory diseases.1 A recent study showed increased activation of the renin–angiotensin system in obese people.2 However, a decrease in angiotensin-converting-enzyme activity may improve the efficiency of peripheral use of oxygen and respiratory muscle function in patients with chronic lung diseases.3 Further, because several studies have shown that inhibition of the renin–angiotensin system may be a useful treatment for secondary erythrocytosis,4–6 such an approach might also have profound benefits in the long-term treatment of erythrocytosis associated with obesity hypoventilation syndrome. Therefore, we suggest that therapy with angiotensin-converting-enzyme inhibitors or angiotensin II type 1 receptor blockers should be considered in the treatment of chronic respiratory diseases in obese people.

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