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(Hypertension. 2008;52:801.)
© 2008 American Heart Association, Inc.
Editorial Commentaries |
From the Department of Medicine, Medical College of Wisconsin, Milwaukee.
Correspondence to Theodore A. Kotchen, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226. E-mail tkotchen@mcw.edu
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Overweight and obesity are established risk factors for hypertension, and hypertension is approximately twice as prevalent in the obese than in the nonobese. The prevalence of overweight and obesity has been increasing in the United States for at least the past 2 decades. These increases have occurred in children, adolescents, and adults, as well as in both genders and in all racial/ethic groups.1,2
Based on an analysis of data from 2 National Health and Nutrition Examination Surveys (NHANESs) approximately a decade apart, the article by Cutler et al3 in the current issue of Hypertension reports that the age-standardized prevalence of hypertension increased from 24.4% to 28.9% between 1988–1994 and 1999–2004. The increase was greater for women than men and occurred in all racial/ethnic groups. The analysis further suggests that an increase in body mass index (BMI) accounted for nearly all of the increased hypertension prevalence in men and for a portion of the increased prevalence in women. Furthermore, between the 2 NHANESs, mean systolic blood pressures increased in nonhypertensive individuals and in untreated hypertensive subjects. This upward shift of blood pressures resulted in a decreased percentage of subjects with normal blood pressure and an increased percentage with prehypertension.
Given the extensive evidence supporting a relationship between obesity and hypertension, the hypothesis that an increased BMI contributes to the increased prevalence of hypertension is plausible. Nevertheless, the relationship between overweight or obesity and hypertension is complex. Hypertension is not an invariable consequence of obesity. In addition, recent evidence suggests that blood
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