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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two blood pressure (BP) measurements separated by 3 months were performed according to international guidelines on 2976 students (11 to 19 years) of different economic levels. Obesity was defined based upon height and weight. With the first measurements, 59th and 95th percentile value distribution curves were defined. Systolic hypertension (SH) was found in 9.5%; 10.2% were males and 8.9% females. The sample showed that 8.1% were obese (240 cases); among them the incidence of SH increased to 28.8% (69 cases) (p less than 0.01). In the entire sample, diastolic hypertension (DH) was 4.3%; males, 2.7%, and females, 5.5% (p less than 0.01). Among obese students, DH increased to 8.3% (20 cases) (p less than 0.01), and showed prevalence figures of 5.8% for obese males and 10.3% (14 cases) for obese females. After a second measurement, DH for the sample decreased to 1.8%. Salt intake and familial antecedents of high BP showed differences between hypertensive and normal populations.
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PMID:Blood pressure levels in urban school-age population in Chile. 729 40

Linear logistic analysis of the relationship of cardiovascular disease risk factors to an overall measure of health effect, ten-year mortality, revealed significant associations of death with systolic blood pressure, age, sex, diabetes mellitus, smoking, cholesterol, obesity (Quetelet index), race and social index. Attributable risk and population attributable risk estimates were derived from the model by changing actual variable values to target values. The results confirmed systolic hypertension and smoking as major public health problems and diabetes mellitus as a powerful risk factor for death. The small detrimental effect of cholesterol on probability of death limits the potential for an overall beneficial effect of preventive intervention. In fact, drug intervention in two reported trials of cholesterol reduction had negative overall effects. Demonstration of the association of a characteristic with a specific disease state does not alone justify attempts to eliminate the high risk state from a population. An overall detrimental health effect must be documented by suitable studies before trials of preventive intervention are undertaken or recommendations made to the public.
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PMID:Logistic model estimation of death attributable to risk factors for cardiovascular disease in Evans County, Georgia. 739 48

Clinical factors associated with urinary albumin excretion (UAE) in type II diabetes are less well known than in type I diabetes. To examine the factors associated with UAE in type II diabetes, 933 Appropriate Blood Pressure Control in Diabetes Trial patients were classified according to UAE status: normoalbuminuria (< 20 micrograms/min), microalbuminuria (20 to 200 micrograms/min), and macroalbuminuria (> 200 micrograms/min). The class of UAE was then correlated with various clinical factors. Using univariate analyses, Hispanic ethnicity, African-American race, male gender, poor glycemic control, insulin use, long duration of diabetes, dyslipidemia, diastolic and systolic hypertension, smoking, and obesity were significantly correlated with microalbuminuria and macroalbuminuria. Using multivariate logistic regression analyses controlling for diabetes duration, glycosylated hemoglobin, gender, and race, the most significant predictors of microalbuminuria and macroalbuminuria were systolic hypertension, body mass index, high-density lipoprotein cholesterol, insulin use, and smoking pack-years. Of these factors, several are potentially reversible with aggressive intervention.
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PMID:Clinical factors associated with urinary albumin excretion in type II diabetes. 777 79

Mild hypertension is currently defined as systolic blood pressure between 140 and 160 mm Hg. The prevalence of systolic hypertension (including this mild category) in individuals 65 and older is 21% for men and 23% for women. Risk factors include obesity, excessive sodium and alcohol consumption, and possibly calcium and bone metabolism. Determinants of arterial wall rigidity and subsequent increase in pulse-wave velocity are also clearly factors. Much of the associated disease occurs in individuals with systolic pressures between 140 and 159 mm Hg. A particularly high-risk group appears to be those with an elevated systolic blood pressure and a low diastolic blood pressure. Systolic hypertension has now been found to be related to the progression of peripheral atherosclerosis, with lower progression rates among treated individuals. In addition, the beneficial effects of antihypertensive therapy have been found to be strongest among individuals with evidence of subclinical peripheral atherosclerosis. The high prevalence of mild systolic hypertension and its clear association with atherosclerotic disease suggests that older individuals with early systolic hypertension should be identified and treated. Clinical trials to test the efficacy of such treatment should be a high priority, perhaps in subgroups with early subclinical disease.
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PMID:Causes, implications, and treatment of systolic hypertension. 792 51

The purpose of this study was to evaluate the effects of the alpha 1-blocking agent terazosin on blood pressure (BP) and blood lipids in a large, variant population of patients with hypertension. A total of 16,917 patients with hypertension were evaluated at 2214 primary and community care facilities; 7808 of these patients had not been treated previously for hypertension; 3928 were switched to terazosin from another antihypertensive agent; and 5181 received terazosin in addition to an agent that had not controlled their hypertension. Terazosin produced highly significant reductions in systolic (-18.2 +/- 0.2 mm Hg) and diastolic (-13.2 +/- 0.1 mm Hg) BP when used as monotherapy (mean dose, 3.1 mg; range, 2 to 10 mg) without causing a significant increase in heart rate. Equal antihypertensive efficacy was demonstrated in men, women, blacks, and whites of all ages, with particular benefit to elderly patients (> or = 65 years of age) with systolic hypertension. Comparative studies indicated that terazosin had equal antihypertensive efficacy in combination with diuretics, beta-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors. Patients who had not responded to monotherapy with one of these classes of antihypertensive drugs showed significant reductions of BP after terazosin, in the following average doses, was added to diuretics, 3.1 mg; beta-blockers, 3.4 mg; calcium channel blockers, 3.3 mg; and ACE inhibitors, 3.4 mg. Terazosin produced highly significant reductions in blood levels of total cholesterol (-5.0%), triglycerides (-6.1%), and low-density lipoprotein cholesterol (-7.6%) without change in high-density lipoprotein cholesterol when used as monotherapy. Similar favorable effects on blood lipid levels were demonstrated when terazosin was used in combination with all other classes of antihypertensive drugs. The greatest reductions in blood cholesterol (-9.2%) were observed among patients with hyperlipidemia (total cholesterol > or = 240 mg/dL). Terazosin maintained its antihypertensive efficacy and was well tolerated by patients with a variety of concomitant diseases, including congestive heart failure, peripheral vascular disease, chronic obstructive pulmonary disease, benign prostatic hyperplasia, diabetes, and obesity. Adverse effects occurred in 17.9% of patients and caused 2.2% to drop out of the study. The most frequent adverse effects were dizziness (4.8%), headache (2.5%), and asthenia (2.4%). Only 0.4% suffered syncope and 0.2% impotence. These data demonstrate the usefulness of terazosin as monotherapy or add-on therapy for treatment of hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Alpha 1-blockade for the treatment of hypertension: a megastudy of terazosin in 2214 clinical practice settings. 792 16

The relationship of body mass index, body fat, waist to hip ratio, fasting blood glucose and sum of blood glucose levels during oral glucose tolerance test with casual blood pressure (BP) and BP parameters obtained by 24h ambulatory BP monitoring in 97 out-patients moderately obese (66 with android type obesity), normal glucose tolerance and mild hypertension at entry study, has been evaluated. A negative correlation between body mass index and systolic ambulatory BP levels as the 24h mean, daytime and nighttime, has been documented in all of the obese subjects; no correlations between body mass index and casual BP were shown. Only in the group of android type obese was the body mass index correlated positively with the casual DBP. Systolic 24h and nighttime BP values correlated positively with waist to hip ratio; the correlation coefficients improved in the subgroup of android type obese. By using 24h ambulatory BP monitoring, it may be possible to show that waist to hip ratio is a better predictor of systolic hypertension than other parameters such as those derived from weight and height measurements and body fat percentage.
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PMID:Ambulatory blood pressure monitoring in evaluating the relationship between obesity and blood pressure. 802 4

It is well known that mean blood pressure (BP) is higher in obese subjects. However, the nature of the relationships between hypertension and obesity is not fully understood; this concerns especially the role of carbohydrate metabolism and sympathetic activity. The aim of this study is to compare hypertensive (systolic BP > or = 160 mmHg) to normotensive men at different levels of body mass index (BMI). We analyzed data from the Paris Prospective Study I concerning 6,424 men aged 40-53 years at entry, who were not treated for hypertension, diabetes and had no sign of heart disease. The biological parameters were glucose and insulin levels, both assessed fasting (G0, I0) and two hours after a 75-g oral glucose load (G2, I2), free fatty acids and cortisol levels. Hypertensive subjects had significantly higher G0 and G2 levels in all BMI tertiles (p < 0.001). On the contrary, I0 was significantly higher only in the third BMI tertile, and the difference in I2 level between hypertensive and normotensive subjects increased with BMI. Free fatty acids level was significantly higher in hypertensives in all BMI tertiles, however, it showed a significant negative trend with BMI (p < 0.0001) which was not present in normotensives. Morning cortisol level showed the same tendency as well and the mean difference between hypertensive and normotensive men decreased with increasing BMI. In conclusion, (1) relative hyperglycemia is present in subjects with systolic hypertension at all BMI levels, while hyperinsulinemia is found only in the more corpulent ones, and (2) free fatty acids and cortisol levels are particularly elevated in lean hypertensive men.
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PMID:[Biological characteristics of arterial systolic hypertension in relation to the degree of obesity in a middle aged active population]. 812 23

Numerous surveys have shown that in industrial countries diabetic subjects develop hypertension more frequently than non-diabetic persons. In fact, three typical hypertension forms in these patients can be discerned: essential, renal, and isolated systolic hypertension. In type 2-diabetes (NIDDM) hypertension can be seen in close association with obesity, glucose intolerance, lipid changes, and insulin resistance within the framework of the metabolic syndrome. The increased incidence of hypertension in type 1-diabetes (IDDM) is a result of development of diabetic nephropathy. In the elderly type 2-diabetics particularly frequently isolated systolic hypertension is present which reflects increased arterial stiffness and loss of vascular distensibility. In hypertension progression of both macrovascular disease and microangiopathy is increased whereby interaction of hyperglycemia and hypertension seems to be the main risk factor. In most hypertensive diabetic patients drugs will be necessary to lower blood pressure in a therapeutical range. There are several effective substances available which should be prescribed individually according to the needs and accompanying conditions in these patients.
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PMID:[Hypertension and diabetes mellitus]. 847 40

In the United Arab Emirates, coronary heart disease has emerged as the leading cause of mortality over a 20-year period of rapid socioeconomic development. CHD risk factors of non-insulin dependent diabetes mellitus (NIDDM), obesity and hypertension were investigated by community based survey among a bedouin-derived Emirati population sample of 322 subjects (> or = 20 years). Diagnosis of diabetes was based on a random capillary blood glucose level > or = 11.1 mmol l-1. Overall diabetes prevalence was 6% (11% in male and 7% in female subjects aged 30-64 years). Urban residence was associated with higher blood glucose levels (P = 0.000), and with higher Body Mass Index (BMI) values (P = 0.002): 27% of all urban residents were obese (BMI > or = 30). The Shamsi were positively associated with higher blood glucose levels compared with other tribal groups (P = 0.000). Female gender was associated with higher BMI values (P = 0.000). Between 19 and 25% of all subjects (male or female; urban or rural residents) have systolic hypertension (> 140 mm Hg). Male gender was associated with raised diastolic BP (P = 0.023). Diabetes was associated with higher mean systolic (P = 0.0274) and diastolic (P = 0.0132) BP levels. Differences in lifestyle between urban and rural residents are becoming blurred with further socioeconomic development and it is expected that the incidence of these CHD risk factors will continue to rise. Further studies are needed to specify changes associated with urbanization. Tribal influence also merits further study given the tradition of consanguinity in the UAE and the genetic basis to NIDDM.
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PMID:Diabetes, obesity and hypertension in urban and rural people of bedouin origin in the United Arab Emirates. 854 23

We screened 1.080 individuals of both sexes between 15 and 75 years old of a rural population of Gral. Belgrano (Prov. of Bs As) in order to assess: 1) prevalence of hypertension (HP) 2) state of awareness of the population about hypertension and 3) treatment and control of the hypertensive population. The sample represented 11% of the population between 15 and 75 years old. BP was measured 3 times in one occasion and the average of these determinations was used to state prevalence. The prevalence of HP (BP > or = 140 and/or 90 mmHg) was 39.8% (35.1% for women and 44.9% for men, P < 0.001) (Fig. 2). The prevalence of diastolic hypertension (DHP) was 22.4% in women and 30.1% in men whereas the prevalence of systolic hypertension (SHP) was 9.6% and 12% respectively. 47% of the hypertensive individuals were aware of being hypertensive and 13% of this group were without pharmacological treatment. If we consider the group who was treated (34%) only 7.6% were controlled with the medication. A very high prevalence of this disease was detected in this population. It will be necessary to evaluate obesity and high salt and alcohol intake. The reduction of these risk factors will be of great value for the primary prevention of this disease.
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PMID:[Prevalence of arterial hypertension in a rural population of Buenos Aires]. 854 20


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