Obesity and hypertension: Two epidemics or one?

(June 7, 2004) Bethesda, MD -- Obesity is weighing heavily on America.

Government and private sector health experts now estimate that 65 percent of America's adults are overweight and 31 percent of adults are obese and at risk for chronic diseases such as diabetes and hypertension. The link between obesity and hypertension is well known, but the exact nature of the association between the two disorders remains unclear.

Obesity and Hypertension

With the significant rise in obesity in this last decade comes a corresponding increase in the prevalence of hypertension. Almost 29 percent of the population is hypertensive (having a blood pressure (BP) greater than 140/90 mmHg or using hypertensive medications). The relationship between obesity and BP appears to be linear and exists throughout the non-obese range. But the strength of the association of obesity with hypertension varies among different racial and ethnic groups. Generally, risk estimates suggest that approximately 75 and 65 percent of the cases of hypertension in men and women, respectively, are directly attributable to an overweight condition and obesity.

It is important to recognize that long-duration obesity does not appear necessary to elevate BP, as demonstrated by obesity in children without a condition of hypertension. Therefore, rather than a special case, obesity hypertension should be considered the most common form of hypertension due to unknown reasons.

Many but not all studies suggest that abdominal adiposity or "beer gut" is more closely associated with high blood pressure rather than overall obesity. Obese individuals with elevated intra-abdominal (visceral) fat demonstrate a clustering of coronary heart disease risk factors (i.e., the Metabolic Syndrome). Heretofore, medical researchers believed the accumulation of visceral fat is the central feature of this syndrome. However, recent evidence favors a role for ectopic or inappropriate fat stora


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