Monday, 4 August 2014

Obesity Complication of Hypertension

By Kyle J. Norton

Obesity is defined as a medical condition of excess body fat accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

 How to calculate your BMI index
BMI= weight (kg)/ height (m2)

 Hypertension, also known as high blood pressure is defined as a condition of elevation of systemic arterial blood pressure.

 How Obesity associates with Hypertension
1. According to the study of "
Links between childhood and adult social circumstances and obesity and hypertension in the mexican population" by Beltrán-Sánchez H, Crimmins EM, Teruel GM, Thomas D., posted in PubMed, researchers found that Recent changes in income, nutrition, and infection in Mexico may be responsible for the observed high prevalence of overweight and obesity and the extremely high odds of hypertension among obese young adults.

2. In the abstract of the study of "Health-related quality of life and awareness of hypertension" by Korhonen PE, Kivelä SL, Kautiainen H, Järvenpää S, Kantola I., posted in PubMed, researchers indicated that Impaired HRQoL in hypertensive patients might be secondary to the awareness of hypertension, adverse drug effects, newly diagnosed type 2 diabetes or obesity, not high blood pressure per se.

3. In the abstract of the study of " Dietary phytochemicals and their potential effects on obesity: A review" by González-Castejón M, Rodriguez-Casado A., posted in PubMed, researchers stated that The incidence of obesity is rising at an alarming rate and is becoming a major public health concern with incalculable social costs. Indeed, obesity facilitates the development of metabolic disorders such as diabetes, hypertension, and cardiovascular diseases in addition to chronic diseases such as stroke, osteoarthritis, sleep apnea, some cancers, and inflammation-bases pathologies.

4. According to the study of "Arterial hypertension in overweight and obese algerian adolescents: Role of abdominal adiposity" by Benmohammed K, Nguyen MT, Khensal S, Valensi P, Lezzar A., posted in PubMed, researchers concluded that The prevalence of hypertension is high in overweight and obese adolescents, and higher in boys than in girls. Hypertension and arterial stiffness, as determined by high PP levels, were associated with abdominal adiposity. It is recommended that prehypertension be identified in overweight adolescents and that lifestyle changes be made to avoid its evolution towards obesity and hypertension.

5. In the study of "Role of waist circumference in predicting the risk of high blood pressure in children" by Kovacs VA, Gabor A, Fajcsak Z, Martos E., posted in PubMed, researchers indicated that The ability of WC to detect high-risk normal weight children is controversial. The additional measure of WC among overweight children seems to be relevant in identifying those at increased risk of high BP. Further research with a larger sample size is required in the obese group.

6. in Another study of "Blood pressure: effect of body mass index and of waist circumference on adolescents" [Article in English, Portuguese] by Guimarães IC, de Almeida AM, Santos AS, Barbosa DB, Guimarães AC., posted in PubMed, researchers concluded that BMI and WC values have a strong influence on BP values in adolescents.

7. Etc.

Treatments of Obesity and Hypertension
1. In a study of "Best strategies for hypertension management in type 2 diabetes and obesity" by Allcock DM, Sowers JR., posted in PubMed, researchers indicated that significant research and effort must be put forth to bring blood pressure to goal and delay or prevent target organ damage. Such efforts should frequently include a dihydropyridine calcium channel blocker such as amlodipine. Other agents that are currently underused in this population for the treatment of resistant hypertension include nebivolol, carvedilol, aliskiren, and aldosterone antagonists. Finally, significant potential is seen for darusentan, an endothelin antagonist, if it comes to market.

2. According to the study of "The 2004 Canadian recommendations for the management of hypertension: Part II--Therapy" by Khan NA, McAlister FA, Campbell NR, Feldman RD, Rabkin S, Mahon J, Lewanczuk R, Zarnke KB, Hemmelgarn B, Lebel M, Levine M, Herbert C; Canadian Hypertension Education Program., posted in PubMed, researchers stated
that This document contains detailed recommendations and supporting evidence on treatment thresholds, target blood pressures and choice of agents for hypertensive patients with or without comorbidities. Lifestyle modifications are a key component of any antiatherosclerotic management strategy and detailed recommendations are contained in a separate document. Key recommendations for pharmacotherapy include the following: treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and comorbidities, with particular attention to systolic blood pressure; blood pressure should be lowered to 140/90 mmHg or less in all patients, and 130/80 mmHg or less in those with diabetes mellitus or renal disease (125/75 mmHg or less in those with nondiabetic renal disease and more than 1 g of proteinuria per day); most adults with hypertension require more than one agent to achieve target blood pressures; for adults without compelling indications for other agents, initial therapy should include thiazide diuretics; other agents appropriate for first-line therapy for diastolic hypertension with or without systolic hypertension include beta-blockers (in those younger than 60 years), ACE inhibitors (in non-Blacks), long-acting dihydropyridine CCBs or angiotensin receptor antagonists; other agents appropriate for first-line therapy for isolated systolic hypertension include long-acting dihydropyridine CCBs or angiotensin receptor antagonists; certain comorbidities provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with diabetes mellitus, ACE inhibitors or angiotensin receptor antagonists (or thiazides in patients with diabetes mellitus without albuminuria) are appropriate first-line therapies; and in patients with mild to moderate nondiabetic renal disease, ACE inhibitors are recommended; all hypertensive patients should have their fasting lipids screened and those with dyslipidemia should be treated using the thresholds, targets and agents as per the Recommendations for the management of dyslipidemia and the prevention of cardiovascular disease; and selected patients with hypertension should also receive statin and/or acetylsalicylic acid therapy.

3. In another study of "A comparison of the efficacy and safety of irbesartan/hydrochlorothiazide combination therapy with irbesartan monotherapy in the treatment of moderate or severe hypertension in diabetic and obese hypertensive patients: a post-hoc analysis review" by Neutel JM., posted in PubMed, researcher indicated that Treatment-emergent adverse event rates were similar between treatment groups regardless of the presence of diabetes or body mass index (BMI) status. In patients with moderate or severe hypertension and with a BMI ≥ 30 kg/m(2), initial treatment with irbesartan/HCTZ combination therapy was more effective than irbesartan monotherapy.

4. Etc.
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