Obesity And Hypertension
Margaret E. Woltjer, Ph.D. | May 2005

In recent years we have become increasingly aware of the wide array of medical problems now believed to be associated with overweight and obesity. The newest threat to our well-being to emerge in this century is our appetite. According to the International Obesity Task Force, the epidemic is worldwide. They report that around the globe that over about 300 million are obese. That means a Body Mass Index (BMI) that exceeds 30.0 (1).

Within the United States alone, the rate of extreme or morbid obesity nearly tripled over the past decade. Even more alarming, increasing numbers of children are now being diagnosed with medical disorders previously associated with adult, obesity-linked conditions. In one study conducted by the Centers for Disease Control and Prevention (CDC), the principal investigator reported that among the 4000 adults surveyed in the study between 1994 and 2000, the prevalence of obesity using the criteria BMI of 30.0 or greater rose from 23% to 31%. In the same span of time, the rate of overweight (BMI 25.0 -29.9) increased from 56% to 65% (2).

The impact of obesity on our medical system
Obesity is a complex health issue, but regardless of the underlying reasons for it, the increasing rates of overweight and obesity among adults and children portend higher rates of chronic disorders such as heart disease, diabetes, stroke, arthritis, some forms of cancer, and hypertension.

The World Health Organization reports that obesity can triple the risk of heart disease, with one-third of all deaths globally (about 17 million people) being attributed to heart disease, stroke and related cardiovascular problems. In a study conducted by the CDC, researchers found that the prevalence of cardiovascular disease among obese individuals was twice that of those of normal weight. The impact of how much weight one carries is seen even more clearly in their study. Among the overweight group, 20% of the cardiovascular disease cases were associated with excess weight, while among the obese group, 45% of the cases were associated with excess weight.

It is estimated that health conditions related to obesity and overweight contribute $93 billion a year to national medical expenses (3).

The results of our study using the Nutrition Health Assessment™
We recently compiled data provided by over 40,000 individuals who completed the NHA™. The ages ranged from 13 to 90 years with the majority falling between 30 and 60 years old. Among the many items of interest were questions pertaining to weight, hypertension, and the use of high blood pressure medication. Within the group reporting high blood pressure, the number of men and women were nearly equal (49.6% vs. 50.4%), and of this group, 66.4% indicated that they were taking medication to treat it.

We were particularly interested in looking at the relationship of hypertension and obesity in various age groups. Based upon studies that have been reported, we expected to find that as obese people aged, the incidence of hypertension would be greater. Table 1 shows the percentage of overweight participants in several age categories.

Table 1. Percentage of overweight participants reporting hypertension

Age 50-54 55-59 60-64 65-69
Hypertensive Women 23.5% 29.6% 36.8% 39.0%
Hypertensive Men 32.7% 36.6% 41.4% 45.3%

As seen in the case of both men and women, the incidence of hypertension increases with age in individuals who are overweight. This is consistent with other research results. In fact, it has been reported that hypertension can actually begin at relatively low levels of overweight (4).

It has also been shown that blood pressure can be lowered by losing weight. In one study, researchers found that heart size decreased in participants who lost weight and increased in those whose weight remained unchanged or increased. The researchers found that for individual participants, blood pressure varied directly with changes in body weight and that heart enlargement often followed prolonged hypertension. Even more dramatically, among those participants who lost weight during the study, the size of the left-side chambers of the heart decreased. They concluded that “even a modest degree of weight loss over the long term is highly beneficial in hypertensive overweight-to-obese patients” (5).

While we were interested in learning what effect overweight had on hypertension, we also wanted to discover if the reverse was also true. That is, do people who have high blood pressure tend to be overweight? See Table 2 for the results of this comparison.

Table 2. Percentage of participants with hypertension who were overweight

Age 50-54 55-59 60-64 65-69
Overweight Women 79.8% 76.9% 76.3% 62.2%
Overweight Men 74.0% 67.4% 58.2% 53.4%

As seen in Table 2, the majority of patients who have high blood pressure are overweight. These results, combined with those in Table 1, suggest that while being overweight does not entirely predict that a person will develop high blood pressure, those who do become hypertensive most often are also overweight.

Research on the relationship of overweight/obesity and hypertension maintain that while prevention of weight gain is always best, weight loss through regular physical activity and changes in diet can often help to reduce blood pressure. Therefore, if you are taking medication for high blood pressure and plan to reduce weight, it is advisable that you do so in consultation with your physician as your medication dose may need to be adjusted.

References
  1. Visit www.iotf.org for more information
  2. Margaret D. Carroll, MD et al. Prevalence and Trends in Obesity Among US Adults, 1999-2000 JAMA. 2002;288:1723-1727.
  3. Center for the Advancement of Health. Weighing the Data: Obesity Affects Elderly, Too. 2004. Vol. 9, No. 12.
  4. National Task Force on the Prevention and Treatment of Obesity. Overweight, Obesity, and Health Risk Arch Intern Med. 2000;160:898-904.
  5. Giuseppe S, et al. Effect of body weight changes on 24-hour blood pressure and left ventricular mass in hypertension: a 4-year follow-up. American Journal of Hypertension. 2003. 16(8):634-639.
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