Impact of overweight and obesity on cardiac benefit of antihypertensive treatment
| Autor: | Björn Dahlöf, Eva Gerdts, B. P. Lund, Richard B. Devereux, Kristian Wachtell, G. De Simone, Peter M. Okin, Kurt Boman, Markku S. Nieminen |
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| Přispěvatelé: | Gerdts, E, DE SIMONE, Giovanni, Wachtell, K, Boman, K. |
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Endpoint Determination Endocrinology Diabetes and Metabolism Myocardial Infarction Medicine (miscellaneous) Blood Pressure Overweight Left ventricular hypertrophy Losartan Muscle hypertrophy Body Mass Index Double-Blind Method Internal medicine medicine Humans Myocardial infarction Obesity Antihypertensive Agents Aged Aged 80 and over Nutrition and Dietetics Ejection fraction business.industry Body Weight nutritional and metabolic diseases Middle Aged medicine.disease Stroke Blood pressure Treatment Outcome Echocardiography Hypertension Cardiology Female Hypertrophy Left Ventricular medicine.symptom Cardiology and Cardiovascular Medicine business Body mass index |
| Zdroj: | Nutrition, metabolism, and cardiovascular diseases : NMCD. 23(2) |
| ISSN: | 1590-3729 |
| Popis: | Increased body mass index (BMI) has been associated with increased cardiovascular morbidity and mortality in hypertension. Less is known about the impact of BMI on improvement in left ventricular (LV) structure and function during antihypertensive treatment.Annual BMI, echocardiograms and cardiovascular events were recorded in 875 hypertensive patients with LV hypertrophy during 4.8 years randomized treatment in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy. Patients were grouped by baseline BMI into normal (n = 282), overweight (n = 405), obese (n = 150) and severely obese groups (n = 38) (BMI ≤24.9, 25.0-29.9, 30.0-34.9, and ≥35.0 kg/m(2), respectively). At study end, residual LV hypertrophy was present in 54% of obese and 79% of severely obese patients compared to 31% of normal weight patients (both p 0.01). In regression analyses, adjusting for initial LV mass/height(2.7), higher BMI predicted less LV hypertrophy reduction and more reduction in LV ejection fraction (both p 0.05), independent of blood pressure reduction, diabetes and in-study weight change. During follow-up, 91 patients suffered cardiovascular death, myocardial infarction or stroke. In Cox regression analysis 1 kg/m(2) higher baseline BMI predicted a 5% higher rate of cardiovascular events and 10% higher cardiovascular mortality over 4.8 years (both p 0.05).In hypertensive patients in the LIFE study, increased BMI was associated with less reduction of LV hypertrophy and less improvement in LV systolic function which may contribute to the observed higher cardiovascular event rate of treated hypertensive patients. |
| Databáze: | OpenAIRE |
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