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Query: UMLS:C0028754 (obesity)
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Seven hundred and fifty asymptomatic European subjects aged 16 to 69 years from an urban general practice were screened for various coronary risk factors. Required information was completed for 98.9 percent of the total sample. The incidence of individual risk factors in males and females respectively were: smoking, 52.8 percent and 45.6 percent; obesity, 26.9 percent and 30.9 percent; definite hypertension, 5.6 percent and 4.0 percent; borderline hypertension, 5.3 percent and 5.1 percent; hyperlipidaemia, 12.8 percent and 8.0 percent; impaired glucose tolerance, 1.1 percent and 1.3 percent. Respective figures for males and females with regard to numbers of risk factors present were: one or more risks present, 68.5 percent and 66.9 percent; two or more, 26.5 percent and 23.5 percent; three or more, 8.0 percent and 4.5 percent; four risk factors present, 1.6 percent and 0.3 percent.
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PMID:Distribution of various coronary risk factors in an urban general practice. 27

Essential hypertension is a quantitative abnormality, the pathological effects and risks increasing with the blood pressure level. In Western countries blood pressure rises with age in most individuals, so essential hypertension is more frequent in middle and older age groups. It is likely that an individual's blood pressure level is determined by many interacting factors. These include heredity, which probably acts multifactorially, and many environment influences, including psychological stress and obesity. Specific factors may be of varying importance in different individuals and in different populations. Several physiological mechanisms control the blood pressure level and may be altered in essential hypertension. In early hypertension sympathetic nervous activity is sometimes increased, although in long-standing hypertension this is less marked. Cardiac output may be increased in borderline hypertension but is normal in established hypertension, when total peripheral resistance is increased. Total exchangeable sodium is normal, while the renal pressure-natriuresis balance is altered, so that for a given pressure the hypertension kidney excretes less sodium. In some patients, plasma renin is low, probably as a result of renal adaption to prolonged hypertension. The pathogenic sequence in essential hypertension is uncertain. Increased autonomic activity may cause vasoconstriction in renal and other arterioles and increase cardiac output, leading to a rise in blood pressure. Elevated pressure itself produces structural changes in the resistance vessels, including those of the kidney, which eventually maintain the hypertension even when the initiating stimulus is removed. The way in which heredity and environment influence pathogenic mechanism is also uncertain. Heredity might, for example, influence the autonomic response to stress or the liability to irreversible changes in the resistance vessels or in the kidney. Environmental factors may also increase autonomic activity, enhance vascular reactivity or alter renal function.
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PMID:The pathogenesis of essential hypertension. 40 33

The Tohoku University method of fasting therapy was performed on 380 patients. The clinical results revealed an efficacy rate of 87%. With regard to psychosomatic diseases, irritable colon syndrome, neurocirculatory asthenia, mild diabetes mellitus, obesity and borderline hypertension were good indications for this therapy. In order to clarify the therapeutic mechanism, several clinical examinations were administered before, during and after therapy. EEG data was analysed according to the power spectral method. The peak frequency decreased as fasting progressed, while it increased as re-fed continued. Percent energy of alpha waves after fasting therapy was significantly higher than that of the pre-fasting stage. The dexamethasone suppression rate of urine 17-OHCS after fasting therapy was significantly lower than that of the pre-fasting stage. It seems that ketone nutrition may work as a strong stressor in the brain cell, temporarily placing all biological mechanisms in a stress state and then activating the natural healing power inherent to the human body, thereby bringing about homeostasis.
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PMID:Psychophysiological study on fasting therapy. 55 Jan 77

It has been well known that the fasting therapy which was invented in Medical School of Tohoku University reveals an excellent effect upon various kinds of psychosomatic diseases, but its therapeutic mechanism and suitable indication are not yet explained completely. In order to corroborate these problems, this study was undertaken on 262 cases of psychosomatic diseases in the field of internal medicine. It is a complete fasting for 10 days with nothing by mouth except for drinking water, and 500 ml of parenteral fluid containing vitamins are administered intravenously every day. Absolute bed rest and self meditation are required in a closed individual room, and patients are not allowed to meet anyone but physicians and nurse in charge. The return to normal ordinary diet follows the order of fluid diet, soft diet and semiordinary diet during 5 days. In the period of the therapy, various clinical and laboratory examinations were carried out. Significance of these examinations consists in prediction of possible danger during the fasting period and elucidation of its therapeutic mechanism. Consequently, an outstanding efficacy rate of 87% with excellent prognosis was attained, and the following diseases were determined as suitable indication of this therapy; irritable colon, dysorexia nervosa, borderline hypertension, neurocirculatory asthenia, bronchial asthma, mild diabetes mellitus, obesity, lumbago without organic findings, conversion hysteria, various neurosis with somatic symptoms and masked depression. Possible mechanism of action of the therapy is that fasting acts as an extreme stress on the function of the autonomic nervous and endocrine systems, then it regulates the function of whole body including the brain, also it acts as one of the behaviour therapy for abnormal conditioning.
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PMID:Fasting therapy for psychosomatic diseases with special reference to its indication and therapeutic mechanism. 96 29

We report on the prevalence of chronic heart failure (CHF) in a random sample of a population (aged 20-64 years) from the Veneto region in northern Italy. The relationship between CHF and hypertension and obesity was also investigated. These data were collected during an international research project coordinated by the World Health Organization. The overall prevalence of CHF was 2.0% both in the male and female population. The prevalence of CHF increased significantly with age and was positively correlated with body mass index in both sexes. Patients with borderline hypertension showed a 3.5-fold increased prevalence of CHF. The prevalence of CHF was 4.9-fold higher in hypertensive than in the normotensive subjects. Patients treated with hypotensive drugs had a significantly higher prevalence of CHF than untreated patients.
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PMID:[Heart failure in the population: prevalence data]. 129 74

A total of 1470 students in Berlin, Germany, between the ages of 7 and 22 years were screened for cardiovascular risk factors such as hypercholesterolemia, hypertension, obesity, smoking habits, and a positive family history. Only 56% had no modifiable risk factor; however, 16% showed total cholesterol (TC) levels of 200 mg/dl. 1% experienced severe and 11% experienced borderline hypertension. In addition, 21% were overweight, and 27% of the adolescents (or+ 15 years of age) admitted to regular smoking. In this paper, the authors focus on cholesterol findings in this study; i.e., the dependence of TC on sex, age,weight, and use of oral contraceptives (OCs). There was an age dependency in both sexes. In boys, the lowest TC levels were seen in the 12-17 year group, whereas those under age 10 had the highest. In those over age 17, TC was higher than among the younger group. In girls, the age dependency of the TC levels was similar, but less pronounced. The minimum level was reached earlier, among those aged 14-15, rather than among those aged 16-17. TC levels in girls as compared to boys were significantly higher in those aged 12-13 and 16-17. Girls who used OCs experienced significantly higher TC levels. Obesity had no influence on TC. These results support the demand for screening for cardiovascular risk factors in children.
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PMID:Cardiovascular risk factors in schoolchildren. 161 98

Twenty obese women aged 45-65 years with borderline hypertension were allocated randomly to either a group with an energy-restricted diet or to a control group. Body weight, blood pressure, urinary sodium, and urinary excretion of norepinephrine and plasma volume were recorded. Resting muscle sympathetic nerve activity was measured in the peroneal nerve by tungsten microelectrodes and expressed as bursts per minute. These measurements were repeated after 3 days of semistarvation and after a body weight reduction of 7% while each patient's weight was in a steady state. After 3 days of semistarvation, only body weight was reduced, whereas after the long-term energy intake restriction, there were reductions of body weight (79.9 +/- 3.4 versus 74.1 +/- 3.4 kg; p less than 0.001), diastolic blood pressure (93 +/- 3 versus 86 +/- 4 mm Hg; p = 0.01), and muscle sympathetic nerve activity (49 +/- 2 versus 42 +/- 3 bursts/min; p less than 0.05). Other variables were unchanged. There were no changes in body weight, blood pressure, or muscle sympathetic nerve activity in the control group. We conclude that body weight decrease in obesity results in a reduction of blood pressure that is at least partially caused by a reduction of sympathetic vasoconstrictor activity.
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PMID:Effect of energy-restricted diet on sympathetic muscle nerve activity in obese women. 174 59

The mass of left ventricular (LV) muscle plays a central role in hypertension. Echocardiographic LV mass has been shown to reflect the level of blood pressure over time, obesity, diet, and other factors, and to serve as the strongest predictor yet discovered, other than advancing age, of cardiac complications of hypertension. Recent research suggests, in addition, that individuals destined to become hypertensive have increased LV mass before hypertension becomes clinically apparent. Several published studies have compared LV mass in groups of normotensive children to young adults considered to be at high or low genetic risk of hypertension based on the presence or absence of hypertension in their parents. In each instance LV mass was higher in the offspring of hypertensive parents and this difference exceeded that expected for small differences in body habitus or arterial pressure. A longitudinal study in children also showed that LV mass predicted subsequent blood pressure level. We recently performed a study of 132 initially normotensive employed adults, 15 (11%) of whom developed borderline hypertension during a 5-year follow-up. The development of hypertension was not predicted by subject age, body habitus, blood pressure, or a variety of biochemical measurements. The only baseline measurement that predicted development of hypertension was that of LV mass (92 +/- 25 v 77 +/- 19 g/m2, P less than .005), and the likelihood of developing hypertension increased progressively from 3% in the lowest quartile of LV mass of 24% in the highest quartile.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Left ventricular mass as a predictor of development of hypertension. 183 89

Borderline hypertension, a condition in which the blood pressure oscillates between normal and high values, is a predictor of future more severe hypertension. Pathophysiologically, borderline hypertension is different from established hypertension. A large proportion of such patients have elevated cardiac output and a normal vascular resistance. In established hypertension, the output is normal and resistance is elevated. The elevation of cardiac output in borderline hypertension is neurogenic; it can be abolished by an autonomic blockade of the heart. In addition to an increased cardiac sympathetic drive, increased sympathetic tone to the kidney, arterioles, and veins has also been found. In parallel with the hypersympathetic state, patients with borderline hypertension also show decreased parasympathetic tone. The enhanced sympathetic tone leads to a decreased cardiac responsiveness, and eventually, the cardiac output returns to the normal range. High blood pressure causes vascular hypertrophy, and hypertrophic vessels are hyperresponsive to vasoconstriction. These secondary changes in the responsiveness of the heart and blood vessels are the basis of transition from a high cardiac output to high-resistance hypertension. These hemodynamic changes are associated with a downregulation of the sympathetic tone. A picture of an apparently nonneurogenic high-resistance hypertension emerges. Nevertheless, when assessed in regard to the enhanced pressor responsiveness, the sympathetic drive in such patients is still excessive. Despite the apparently normal tone, the sympathetic nervous system continues to play an important pathophysiological role in established hypertension. Borderline hypertension is associated with numerous metabolic abnormalities including obesity and insulin resistance. It is tempting to view all these abnormalities as a common expression of the increased sympathetic drive in hypertension. Explanation of the basis of the association of hypertension and metabolic abnormalities promises to bring new insights into the pathophysiology of two common diseases of civilization: hypertension and diabetes mellitus.
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PMID:Autonomic nervous dysfunction in essential hypertension. 204 40

To determine whether obesity alters responsiveness to vasoactive drugs, we compared the cardiovascular effects of angiotensin, phenylephrine and isoproterenol in unanesthetized age-matched control and obese Oscai rats. Obesity was induced by programming pups to overeat immediately after birth and then feeding them a high-fat diet thereafter. Elevations in tail-cuff systolic and mean pressures from 7 through 11 months of age and in plasma insulin at 8 months of age indicated that obese rats had developed borderline hypertension and hyperinsulinemia. Cardiovascular responsiveness was then tested by recording blood pressure, heart rate and renal blood flow from chronically implanted arterial catheters and flow probes while graded doses of the three test drugs were infused intravenously. Heart rate and renal blood flow decreased during pressor responses to angiotensin and phenylephrine and were oppositely increased during depressor responses to isoproterenol. Magnitude of all cardiovascular receptors was dose-dependent. Obese rats had weaker reflex bradycardic responses to angiotensin and phenylephrine than control rats. More importantly, they also had larger renal vasoconstrictor responses to 2 ng/100 g of angiotensin or vasodilator responses to 15 ng/100 of isoproterenol. Whether or not the changes in cardiovascular responsiveness were related to hyperinsulinemia was undetermined. Our results suggest that, in addition to being overweight, slightly hypertensive and hyperinsulinemic, obese Oscai rats have impaired baroreflexes and a renal vascular bed more responsive to beta adrenergic vasodilation.
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PMID:Renovascular beta adrenergic hypersensitivity and hyperinsulinemia in rats with dietary-induced obesity. 217 Jun 25


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