Impact of overweight and obesity on cardiac benefit of antihypertensive treatment

Gerdts, Eva; Simone, Giovanni de; Lund, B. P.; Okin, Peter M.; Wachtell, Kristian; Boman, Kurt; Nieminen, Markku S.; Dahlöf, Björn; Devereux, Richard B.

doi:10.1016/j.numecd.2011.03.008

Cited by 28 publications

(14 citation statements)

References 34 publications

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“…In the Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) study, clusters of metabolic risk factors, including obesity, were associated with less reduction of electrocardiogram‐LVH in both diabetic and nondiabetic groups . Similar findings were produced in 875 patients recruited in the LIFE echo substudy . One of the reasons in the lack of reduction of LVM in obesity might be in the myocardial composition of obese subjects.…”

Section: Discussionmentioning

confidence: 62%

Lack of Reduction of Left Ventricular Mass in Treated Hypertension: The Strong Heart Study

Simone

Devereux

Izzo

et al. 2013

JAHA

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BackgroundHypertensive left ventricular mass (LVM) is expected to decrease during antihypertensive therapy, based on results of clinical trials.Methods and ResultsWe assessed 4‐year change of echocardiographic LVM in 851 hypertensive free‐living participants of the Strong Heart Study (57% women, 81% treated). Variations of 5% or more of the initial systolic blood pressure (SBP) and LVM were categorized for analysis. At baseline, 23% of men and 36% of women exhibited LV hypertrophy (LVH, P<0.0001). At the follow‐up, 3% of men and 10% of women had regression of LVH (P<0.0001 between genders); 14% of men and 15% of women, free of baseline LVH, developed LVH. There was an increase in LVM over time, more in men than in women (P<0.001). Participants whose LVM did not decrease had similar baseline SBP and diastolic BP, but higher body mass index (BMI), waist/hip ratio, heart rate (all P<0.008), and urinary albumin/creatinine excretion (P<0.001) than those whose LVM decreased. After adjusting for field center, initial LVM index, target BP, and kinship degree, lack of decrease in LVM was predicted by higher baseline BMI and urinary albumin/creatinine excretion, independently of classes of antihypertensive medications, and significant effects of older age, male gender, and percentage increase in BP over time. Similar findings were obtained in the subpopulation (n=526) with normal BP at follow‐up.ConclusionsIn a free‐living population, higher BMI is associated with less reduction of hypertensive LVH; lack of reduction of LVM is independent of BP control and of types of antihypertensive treatment, but is associated with renal damage.

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Section: Discussionmentioning

confidence: 62%

Lack of Reduction of Left Ventricular Mass in Treated Hypertension: The Strong Heart Study

Simone

Devereux

Izzo

et al. 2013

JAHA

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“…Gerdts et al was able to show that despite comparable BP reduction, hypertensive obese individuals with LVH have a blunted response to therapy compared to normal weight patients [44]. Similarly, treated hypertensive adults who did not experience the anticipated decrease in LVM over time in the Strong Heart Study had similar BPs to those who did have the anticipated regression, but had greater measures of adiposity (BMI, waist/hip ratio) as well as higher heart rate and albuminuria.…”

Section: Is Weight Loss More Important Than Lowering Bp When Aiming Tmentioning

confidence: 99%

The Role of Obesity in the Development of Left Ventricular Hypertrophy Among Children and Adolescents

Brady

2015

Curr Hypertens Rep

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Both obesity and hypertension have increased substantially among children over the last several decades. At the same time, mounting evidence has pointed to the role of these and other cardiovascular disease risk factors on the development of end organ damage such as left ventricular hypertrophy in children. While traditionally thought to occur in response to an increased afterload as in systemic hypertension, evidence demonstrates that obesity is associated with left ventricular hypertrophy independent of blood pressure. Both hemodynamic and non-hemodynamic factors contribute to the pathogenesis of obesity-related left ventricular remodeling. However, more contemporary research suggests that adiposity and blood pressure have a greater effect on left ventricular geometry when present together than when present alone. Normalization of left ventricular mass in obese hypertensive individuals requires achievement of both normotension and weight loss. Additional strategies are needed to promote the cardiovascular health of children, with greater emphasis placed on obesity prevention.

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“…According to criteria based on left-ventricular mass indexed to BSA, LVH prevalence ranged from 22.0 [27] to 67.0% [21]; the corresponding figures for left-ventricular mass indexed to height 2.7 were 20.0 [17] and 85.0% [32]. A meta-analysis aimed at comparing the prevalence of LVH in normotensive (six studies, 418 participants) [17][18][19]26,31,35] and hypertensive obese individuals (eight studies, 1976 participants) [15,16,21,22,28,29,32,33], and failed to find significant difference between the groups (54 versus 59%; P ¼ 0.44).…”

Section: Left-ventricular Hypertrophy Prevalencementioning

confidence: 99%

“…Fifteen out of 22 studies [15][16][17][18][20][21][22][23][25][26][27][28][29]31,32] provided data on LVH prevalence in obese (n ¼ 4999) as compared to non-obese controls (n ¼ 6623). As reported in Fig.…”

Section: Comparison Between Obese Individuals and Non-obese Controlsmentioning

confidence: 99%

“…2, all but two studies [16,17] revealed a higher LVH prevalence in obese compared to their non-obese counterparts (OR 4.19, 95% CI 2.67-6.57, P < 0.01). Figure 3 reports the results of the meta-analysis from 11 studies [15,[17][18][19][20][21]23,28,29,31,32] providing data on average left-ventricular mass indexed to height 2.7 and SD in 2554 obese individuals and 3340 non-obese controls. The standardized difference in means was positive in favour of obese individuals (OR 0.96, 95% CI 0.72-1.22, P < 0.01).…”

Section: Comparison Between Obese Individuals and Non-obese Controlsmentioning

confidence: 99%

See 1 more Smart Citation

Left-ventricular hypertrophy and obesity

Cuspidi

Rescaldani

Sala

et al. 2014

Journal of Hypertension

176

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Impact of overweight and obesity on cardiac benefit of antihypertensive treatment

Cited by 28 publications

References 34 publications

Lack of Reduction of Left Ventricular Mass in Treated Hypertension: The Strong Heart Study

Lack of Reduction of Left Ventricular Mass in Treated Hypertension: The Strong Heart Study

The Role of Obesity in the Development of Left Ventricular Hypertrophy Among Children and Adolescents

Left-ventricular hypertrophy and obesity

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