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

Efficacy and acceptability of perindopril (Coversyl) in general practice were evaluated in 23,460 hypertensive patients (52.9% women) during an open six month trial. Patients had essential mild to moderate hypertension (94 mmHg < supine DBP < 115 mmHg) associated or not with obesity (34%), diabetes (12%), hypercholesterolemia (36%), smoking habits (24%). Mean hypertension duration was 6.5 years, 70 p. cent of patients were 50 to 69 years old and 12 p. cent 70 years old or more. Perindopril was started at 4 mg except in older and patients with renal insufficiency (2 mg). If supine DBP remained > 90 mmHg the dose was doubled up to 8 mg/day, then a thiazide diuretic was added. Monotherapy was held in 90 p. cent of cases all along the study, more than 8 over 10 times at 2 or 4 mg/day. Normalized patients (DBP < or = 90 mmHg) were 69.87 and 95 p. cent respectively at the first, third and sixth month. Mean supine SBP and DBP decrease were 27.3 and 18.0 mmHg. Antihypertensive activity was similar in patients taking psychotrope or non steroidal anti-inflammatory agents and in others, as well as in older (> or = 70 years), diabetics and obeses, however with a significantly more frequent bitherapy in these last three sub-groups. Cough, a well known side effect of ACEI led to withdrawal in only 2.6 p. cent of cases. Withdrawals for side-effect were more frequent in older patients (6.1%), in those taking psychotrope (5.3%) or non steroidal anti-inflammatory agents (6.0%) than in diabetics (4.1%) or the others (4.1%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Antihypertensive action, clinical and biological acceptability of perindopril: main results in 23,460 patients with mild to moderate hypertension treated for 6 months in general practice]. 848 Sep 86

We analysed the association of body mass index (BMI) with blood pressure (BP) at baseline, whether BMI predicts the incidence of anti-hypertensive drug treatment during a 12-year follow-up and whether this risk is independent of the original BP level and, finally, how diabetes associates with the incidence of anti-hypertensive drug treatment. The study population comprised 15,438 men and women in eastern Finland aged between 30 and 59 years who were not using anti-hypertensive drug treatment during baseline surveys in 1972 and 1977. At baseline BP increased linearly by increasing BMI. The proportion of hypertensive subjects, defined as either DBP > or = 95 mm Hg or SBP > or = 160 mm Hg, was 18% among the leanest men, BMI < 20 kg/m2, but 61% among the most obese, BMI > or = 30 kg/m2. Among women these proportions were 11% and 54%, respectively. Among the normotensive subjects at baseline, the BMI associated risk ratio of the incidence of anti-hypertensive drug treatment, adjusted for age and study year, was 1.14 (per kg/m2; P < 0.001) in men and 1.11 (P < 0.001) in women. After a further adjustment for DBP and SBP at baseline, risk ratios were 1.13 (P < 0.001) and 1.07 (P < 0.001), respectively. Diabetes associated with the risk of anti-hypertensive drug treatment independently from BMI, DBP and SBP. Because BMI correlates with BP cross-sectionally, and it also predicts the future increase in BP independently from the baseline BP, excess weight is undoubtedly one of the most important risk factors for hypertension. Weight control is the most natural primary intervention method in the inter-relation of obesity, hypertension and diabetes and in the prevention of subsequent cardiovascular diseases.
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PMID:Body mass index, blood pressure, diabetes and the risk of anti-hypertensive drug treatment: 12-year follow-up of middle-aged people in eastern Finland. 857 2

In order to elucidate the significance of high normal blood pressure in occupational health care, a 5 year follow up survey was performed on 874 men with normal blood pressure and 225 men with high normal blood pressure. The major results of this survey were as follows. 1) Sixty-seven out of 874 with normal blood pressure (7.7%), and 78 out of 225 with high normal blood pressure (34.6%) became hypertensive in 5 years. 2) High normals started with a higher frequency of obesity, hypercholesterolemia, hyper gamma-Glutamyl transpeptidasemia compared with normal blood pressure at the start of the survey. 3) Logistic regression analysis showed that age, SBP, DBP were risk factors of developing hypertension from normal blood pressure, while only the amount of alcohol drinking applied for high normal blood pressure. 4) Logistic regression showed that high normal blood pressure, drinking, obesity and were significantly related to the development of hypertension. These results suggested that interventive activities for high normal blood pressure should be included in occupational health care because of a high tendency of underlying poor life style and a high risk of getting hypertension.
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PMID:[Significance of high normal blood pressure in occupational health care]. 885 Nov 83

In an investigation on hypertension risk factors, the entire school population was examined in Trecchina, a southern Italian village. The reported findings refer to those children examined together with at least one parent, for a total of 134 mother-child pairs and 128 father-child pairs. For these groups of children, fathers and mothers, systolic (SBP) and diastolic (DBP) blood pressure, weight (W), height (H) and triceps skinfold (TS) were detected and body mass index (BMI) was calculated in order to evaluate the prevalence of high blood pressure (BP) values and if overweight. Of 19.3% children, 26.9% fathers and 15.8% mothers showed high BP values; 28.9% of children, 14.0% of fathers and 19.3% of mothers were overweight. In children, the analysis of correlations, after adjustment for height, showed a significant association between BP and W, BMI and TS. Using multiple regression analysis, with BP as the dependent variable, SBP was significantly associated with BMI and age in mother and fathers. For DBP the only variable entered in the model was BMI for mothers and fathers. When controlling for the children's age, H, W and BMI of children were significantly related to H, W and BMI of mothers and fathers. These results confirm that overweight and a parental history of obesity are predictive and possibly causal factors for essential hypertension.
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PMID:Blood pressure and anthropometry in parents and children of a southern Italian village. 887 32

DESPITE THEIR HIGHER PREVALENCE of obesity and diabetes, Hispanics have lower or equal rates of hypertension than non-Hispanic whites (1-4). Healthy People 2000 objectives call for increasing the proportion of hypertensive men whose blood pressure is under control to at least 40%. In addition, the objectives recommend reducing the prevalence of overweight to 41% among hypertensive women, and to 35% among hypertensive men (5). The Hispanic Health and Nutrition Examination Survey (HHANES) collected data on Mexican Americans (MA), Cuban Americans (CA), and Puerto Ricans (PR) living in the continental United States. A trained physician measured systolic (SBP) and diastolic (DBP) blood pressure twice in one visit. Our findings provide data to assess baseline estimates for several Healthy People 2000 objectives among Hispanics. Based on criteria from The Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-V), we found Hispanic women to have higher rates of awareness, treatment, and control of hypertension than men. Only 8% of MA and PR men and 9% of CA men who were hypertensive had their high blood pressure under control. The prevalence of overweight among hypertensive men ranged from 39% to 60%; and among hypertensive women, from 44% to 74%. Hispanic women with six or fewer years of education had higher prevalence of hypertension and other cardiovascular disease (CVD) risk factors. Future research should investigate the socioeconomic factors associated with the presence of these risk factors.
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PMID:Hypertension and other cardiovascular disease risk factors among Mexican Americans, Cuban Americans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey. 889 61

Cigarette smoking has been reported to worsen high-density lipoprotein (HDL) cholesterol and other cardiac risk factors, yet no studies have examined this issue among rural African Americans. This study examines the association between cigarette smoking and cardiac risk factors among rural African Americans. A population-based sample of 403 African-American adults from two rural Virginia counties underwent total cholesterol (TC), HDL, systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), serum glucose, and glycosylated hemoglobin (GlyHb) measurements. Cross-sectional multivariate analyses were used to compare risk factors across categories of cigarette use. Age, BMI, alcohol consumption, and the use of antihypertensive medications were covariates in the analysis. Results indicated that female light smokers had significantly lower SBP and DBP, and lower HDL. Female heavy smokers had significantly lower HDL and BMI and significantly higher TC/HDL ratios. Male heavy smokers had significantly higher SBP. More than 33% of males and more than 50% of females were overweight, and increasing BMI was associated with significantly or nearly significantly worsening of all other risk factor levels. Both cigarette smoking and obesity adversely affect other cardiac risk factors. Novel approaches are needed to decrease both smoking and obesity in this difficult to reach population.
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PMID:Coronary heart disease risk factors and cigarette smoking among rural African Americans. 900 15

Little is known about hypertension in Haitians. We performed a pilot survey of ambulatory Haitian patients in a multispecialty clinic at a large public teaching hospital. Approximately 10% of the clinic population was of Haitian origin. Clinical data were collected on 88 consecutive Haitian patients. Of these 88, 77 (87.5%) were hypertensive (SBP > or = 140 or DBP > or = 90 mm Hg or taking antihypertensive medication). The characteristics of the hypertensive patients were: age 54.1 +/- 13.0 (s.d.) years; 27 men, 50 women; 12/64 (19%) smoked; 7/63 (11%) used alcohol. Diabetes was present in 21/77 (27%). In patients for whom height and weight were available, obesity was present in 52%. Using JNC V criteria, 18 (23%) had Stage 1, 16 (21%) Stage 2, 18 (23%) Stage 3, and 25 (33%) Stage 4 hypertension. Despite 63/77 (82%) being treated for hypertension, only 20 (26%) were controlled (< 140/< 90 mm Hg). Of those under treatment, 29 were taking one drug; 18 (two drugs); 12 (three drugs); and four (four drugs). Target organ damage was evident in 37 (48%), including coronary artery disease (8), CHF (6), chronic renal failure (15), stroke (9), and LVH by ECG (19). There was evidence of severe noncompliance in 32 (42%). We conclude that in this clinic sample, hypertension was highly prevalent and unusually severe in terms of blood pressure (BP) level, refractoriness to treatment, and target organ consequences. Further studies are indicated.
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PMID:Hypertension in Haitians: results of a pilot survey of a public teaching hospital multispecialty clinic. 900 4

In Caucasian subjects, an insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with coronary artery disease (CAD) and fatal myocardial infarction. The underlying mechanism(s) of this association is not fully understood. Pima Indians have a low incidence of nonfatal and fatal CAD despite a high prevalence of diabetes. In Pima Indians, circulating ACE levels are related to ACE genotype, but the frequency of the D allele is significantly lower than in Caucasians. A lower frequency of the D allele may underlie a low risk of CAD in this population. We examined the relationship of the ACE genotype and plasma ACE level with electrocardiographic evidence of CAD (Tecumseh criteria), hypertension, and metabolic variables associated with insulin resistance in 305 (146 men and 159 women aged 47+/-9.0 years) Pima Indians characterized for the ACE I/D genotype. The distribution of ACE genotypes was unrelated to diabetes and obesity. Fasting plasma insulin, plasminogen activator inhibitor-1 (PAI-1) activity, plasma triglyceride concentrations, and systolic (SBP) and diastolic (DBP) blood pressure were not significantly different between the three ACE genotypes among nondiabetic and diabetic subjects. There was no significant association of ACE genotype with electrocardiographic evidence of CAD or with hypertension. Plasma ACE concentrations were not significantly different between nondiabetic and diabetic subjects (median, 77 [range, 21 to 1691 v 83 [7 to 238] IU/mL, P=NS). In all subjects, plasma ACE levels were associated weakly with plasma triglyceride (partial r=.20, P < .01) and total cholesterol (partial r=.13, P <.03) concentrations, but not with fasting plasma insulin or PAI-1 activity. In diabetic subjects, ACE levels were related to fasting plasma glucose concentrations (partial r=.15, P=.07). These findings would suggest that ACE gene I/D polymorphism is unlikely to be a major determinant of susceptibility to CAD in Pima Indians. Plasma ACE levels, but not ACE genotype, correlated with lipids, plasma glucose, and blood pressure, suggesting that elevated plasma ACE levels may contribute to the link between insulin resistance and CAD disease or may be a consequence of it.
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PMID:Angiotensin-1-converting enzyme (ACE) gene polymorphism, plasma ACE levels, and their association with the metabolic syndrome and electrocardiographic coronary artery disease in Pima Indians. 959 57

Overall obesity and central fat distribution are frequently accompanied by hyperglycemia, hypertension (HTN) and coronary heart disease (CHD) observed in developed nations and in South Asian migrants. This study attempts to estimate the prevalence of CHD and HTN and to assess the related risks among the newly diagnosed diabetics in the developing communities. From a total of 3583 non-insulin-dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) subjects, the authors investigated 693 (M = 295, F = 398) randomly selected non-smokers of age 30-60 years. WHO diagnostic criteria were used for NIDDM and IGT. Systolic and diastolic hypertension (sHTN and dHTN) were defined as systolic blood pressure (SBP) > or = 140 and diastolic (DBP) > or = 90 mmHg. Diagnosis of CHD was based on electrocardiogram either on rest or on stress or both when equivocal. The overall prevalence of CHD in the NIDDM subjects was 18.6%. The prevalence rates of sHTN and dHTN were 23.2 and 13.6%, respectively. CHD and HTN did not differ significantly between male and female and between urban and rural subjects. CHD prevalence was significantly higher in the higher tertiles of age, SBP and DBP (P < 0.001, for all cases). Logistic regression showed that only the increasing age, high waist-to-hip ratio (WHR) and high BP were the independent risks for CHD. For sHTN, the independent risks were increased age and high body mass index (BMI) (kg/m2). Regardless of sex and area, increased prevalence of CHD and HTN were found in the newly diagnosed diabetic subjects. Increased age, central obesity and HTN were the independent risks for CHD while advancing age and overall obesity was related to sHTN.
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PMID:Blood pressure and coronary heart disease in NIDDM subjects at diagnosis: prevalence and risks in a Bangladeshi population. 959 85

During a 12-week, multicenter study to evaluate the efficacy and safety of lisinopril and hydrochlorothiazide (HCTZ) for the treatment of obesity-related hypertension, ambulatory blood pressure (ABP) monitoring was performed both at baseline and at study completion in 124 patients. Patients were randomized to three groups: placebo, lisinopril (10, 20, or 40 mg/day), or HCTZ (12.5, 25, or 50 mg/day). All groups were matched with regard to sex, race, age, body mass index, and waist/hip ratio. The primary analysis of ABP data revealed that both lisinopril and HCTZ effectively lowered mean 24-h systolic (SBP) and diastolic (DBP) blood pressure compared with placebo, (mean change from baseline SBP/DBP: -12.0/-8.2, -10.6/-5.5, and -0.3/-0.5 mm Hg, respectively); however, lisinopril lowered DBP better than HCTZ (P < .05). Secondary analyses of groups revealed that men responded better to lisinopril than HCTZ (-11.9/-7.3 v -6.6/-3.5 mm Hg, respectively), whereas women responded well to both drugs. White patients responded better to lisinopril than HCTZ, whereas black patients showed a significant response to HCTZ only. Response to treatment was also influenced by patient classification of 24-h blood pressure profiles, ie, "dipper" or "nondipper." Overall, the majority of obese hypertensives were nondippers. Nondippers (n = 82) responded well to both drugs (-10.4/-6.9 v -12.5/-5.7 mm Hg, P < .05 v placebo), whereas dippers (n = 42) responded to lisinopril (-11.7/ -9.4 mm Hg, P < .05 v placebo and HCTZ), but not HCTZ (-5.6/-4.1 mm Hg, P = NS v placebo). Results of 24-h ABP data show that both lisinopril and HCTZ are effective therapies for obesity-related hypertension and that response to treatment is influenced by sex, race, and dipper/nondipper status.
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PMID:Nocturnal reduction of blood pressure and the antihypertensive response to a diuretic or angiotensin converting enzyme inhibitor in obese hypertensive patients. TROPHY Study Group. 971 82


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