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Clinical profile and management of patients with hypertension and chronic ischemic heart disease according to BMI.
Obesity (Silver Spring). 2010 Oct; 18(10):2017-22.O

Abstract

Obesity is associated with numerous risk factors and comorbidities such as hypertension, metabolic syndrome, type 2 diabetes, and cardiovascular diseases. However, numerous studies have reported an obesity paradox; the overweight and obese patients with established cardiovascular disease have better prognosis than those with a BMI <25 kg/m(2). This study was designed to assess potential differences in the clinical profile and management of hypertensive outpatients with chronic ischemic heart disease in obese and lean patients that could explain these two apparently contradictory points. Overweight and obesity were defined as a BMI 25-29.9 kg/m(2) and ≥30 kg/m(2), respectively. Cardiovascular risk factors goals were considered according to European Society of Hypertension-European Society of Cardiology 2003, National Cholesterol Education Program Adult Treatment Panel III and American Diabetes Association 2005 guidelines. A sample of 2,024 patients (66.8 ± 10.1 years; 31.7% women) was included. Of these, 0.1% had a BMI <20 kg/m(2); 17.1% BMI 20-24.9 kg/m(2); 53.7% BMI 25-29.9 kg/m(2); 23.7% BMI 30-34.9 kg/m(2); 4.3% BMI 35-39.9 kg/m(2); and 1.1% BMI ≥40 kg/m(2). The subgroup of patients with BMI ≥30 kg/m(2) had a higher proportion of women, diastolic dysfunction, diabetes, dyslipidemia, left ventricular hypertrophy, and heart failure. There was an inverse relationship between risk factors control rates and BMI (all comparisons BMI 20-24.9 kg/m(2) vs. 25-29.9 kg/m(2) vs. ≥30 kg/m(2)): blood pressure (BP) control (51.7% vs. 42.4% vs. 29.2%, P < 0.001); low-density lipoprotein cholesterol (LDL-C) control (35.2% vs. 30.5% vs. 27.9%, P = 0.03) and diabetes control (38.6% vs. 27.6% vs. 22.2%, P = 0.023). In conclusion, in patients with hypertension and chronic ischemic heart disease, as BMI increases, the clinical profile worsens as well as risk factors control rates.

Authors+Show Affiliations

Department of Cardiology, Hospital Ramón y Cajal, Madrid, Spain. vbarriosa@meditex.esNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

20134413

Citation

Barrios, Vivencio, et al. "Clinical Profile and Management of Patients With Hypertension and Chronic Ischemic Heart Disease According to BMI." Obesity (Silver Spring, Md.), vol. 18, no. 10, 2010, pp. 2017-22.
Barrios V, Escobar C, Calderón A. Clinical profile and management of patients with hypertension and chronic ischemic heart disease according to BMI. Obesity (Silver Spring). 2010;18(10):2017-22.
Barrios, V., Escobar, C., & Calderón, A. (2010). Clinical profile and management of patients with hypertension and chronic ischemic heart disease according to BMI. Obesity (Silver Spring, Md.), 18(10), 2017-22. https://doi.org/10.1038/oby.2010.12
Barrios V, Escobar C, Calderón A. Clinical Profile and Management of Patients With Hypertension and Chronic Ischemic Heart Disease According to BMI. Obesity (Silver Spring). 2010;18(10):2017-22. PubMed PMID: 20134413.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical profile and management of patients with hypertension and chronic ischemic heart disease according to BMI. AU - Barrios,Vivencio, AU - Escobar,Carlos, AU - Calderón,Alberto, Y1 - 2010/02/04/ PY - 2010/2/6/entrez PY - 2010/2/6/pubmed PY - 2011/3/25/medline SP - 2017 EP - 22 JF - Obesity (Silver Spring, Md.) JO - Obesity (Silver Spring) VL - 18 IS - 10 N2 - Obesity is associated with numerous risk factors and comorbidities such as hypertension, metabolic syndrome, type 2 diabetes, and cardiovascular diseases. However, numerous studies have reported an obesity paradox; the overweight and obese patients with established cardiovascular disease have better prognosis than those with a BMI <25 kg/m(2). This study was designed to assess potential differences in the clinical profile and management of hypertensive outpatients with chronic ischemic heart disease in obese and lean patients that could explain these two apparently contradictory points. Overweight and obesity were defined as a BMI 25-29.9 kg/m(2) and ≥30 kg/m(2), respectively. Cardiovascular risk factors goals were considered according to European Society of Hypertension-European Society of Cardiology 2003, National Cholesterol Education Program Adult Treatment Panel III and American Diabetes Association 2005 guidelines. A sample of 2,024 patients (66.8 ± 10.1 years; 31.7% women) was included. Of these, 0.1% had a BMI <20 kg/m(2); 17.1% BMI 20-24.9 kg/m(2); 53.7% BMI 25-29.9 kg/m(2); 23.7% BMI 30-34.9 kg/m(2); 4.3% BMI 35-39.9 kg/m(2); and 1.1% BMI ≥40 kg/m(2). The subgroup of patients with BMI ≥30 kg/m(2) had a higher proportion of women, diastolic dysfunction, diabetes, dyslipidemia, left ventricular hypertrophy, and heart failure. There was an inverse relationship between risk factors control rates and BMI (all comparisons BMI 20-24.9 kg/m(2) vs. 25-29.9 kg/m(2) vs. ≥30 kg/m(2)): blood pressure (BP) control (51.7% vs. 42.4% vs. 29.2%, P < 0.001); low-density lipoprotein cholesterol (LDL-C) control (35.2% vs. 30.5% vs. 27.9%, P = 0.03) and diabetes control (38.6% vs. 27.6% vs. 22.2%, P = 0.023). In conclusion, in patients with hypertension and chronic ischemic heart disease, as BMI increases, the clinical profile worsens as well as risk factors control rates. SN - 1930-739X UR - https://www.unboundmedicine.com/medline/citation/20134413/Clinical_profile_and_management_of_patients_with_hypertension_and_chronic_ischemic_heart_disease_according_to_BMI_ L2 - https://doi.org/10.1038/oby.2010.12 DB - PRIME DP - Unbound Medicine ER -