Obesity and hypertension in a longitudinal study of black physicians: The Meharry Cohort Study

Neser, William B.; Thomas, John M.; Semenya, Kofi A.; Thomas, D J; Gillum, Richard F.

doi:10.1016/0021-9681(86)90066-4

Cited by 48 publications

(26 citation statements)

References 17 publications

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“…28 Thus, weight loss has the potential to be a powerful means of preventing hypertension. Studies have consistently identified an association between obesity and hypertension, independent of age in clinical trials 28,29 longitudinal studies 30,31 and also in cross-sectional studies. 32,33 If the economy continues to improve the percentage of people in the higher BMI will be expected to rise, which would be expected to lead to a higher prevalence of hypertension in this population.…”

Section: Discussionmentioning

confidence: 97%

Hypertension and its determinants among adults in high mountain villages of the Northern Areas of Pakistan

et al. 2001

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We studied the prevalence and determinants of hypertension among adults in mountainous rural villages in the Ghizar district Northern Areas of Pakistan, an area that recently has undergone substantial economic development. We selected a stratified random sample of 4203 adults (age Ͼ18 years) from 16 villages in Punial Valley of Ghizar district where the number of study subjects from each village was proportionate to the size of the village. We obtained blood pressure (BP) records by taking the mean of the second and third BP measurement, using a standard mercury sphygmomanometer, and assessed risk factors for hypertension in the study subjects. The mean ؎ s.

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Section: Discussionmentioning

confidence: 97%

Hypertension and its determinants among adults in high mountain villages of the Northern Areas of Pakistan

et al. 2001

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“…Studies find that between 30 and 58% define themselves as overweight, and 8-18% as obese. 1,2 As part of a physician survey of personal weight management strategies, we investigated physicians' own personal dieting behavior and their diet recommendations to their patients.…”

Section: Introductionmentioning

confidence: 99%

Physicians recommendations for and personal use of low-fat and low-carbohydrate diets

Puma¹,

Szapary

Maki

2004

Int J Obes

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“…11,12 In a longitudinal study of initially normotensive black male medical students, a remarkably high incidence of hypertension was observed even among the physicians who remained lean throughout adult life. 13 Taken together, these epidemiological data led us to hypothesize a major gender difference in the relationship between adiposity and SND in blacks. Specifically, we sought to determine whether sympathetic overactivity is present in lean black men; such overactivity would constitute a potential explanation for a high risk of hypertension independent of obesity.…”

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confidence: 99%

Overweight and Sympathetic Overactivity in Black Americans

et al. 2001

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Abstract-A large body of clinical investigation implicates an important role for the sympathetic nervous system in linking obesity with hypertension. However, the experimental support for this hypothesis is derived from strictly white cohorts. The goal of this study was to determine whether being overweight begets sympathetic overactivity in black Americans, the ethnic minority at highest risk for hypertension. We recorded postganglionic sympathetic nerve discharge with microelectrodes in muscle nerve fascicles of the peroneal nerve in 92 normotensive young adult black men and women within a wide range of body mass index. The same experiments were performed in a control group of 45 normotensive white men and women of similar ages and body mass indices. The major new findings are 2-fold. First, in young, normotensive, overtly healthy black women, being overweight begets sympathetic overactivity (rϭ0.45, Pϭ0.0009), a putative intermediate phenotype for incident hypertension. Second, in black men, sympathetic nerve discharge is dissociated from body mass index (rϭ0.03, PϭNS). This dissociation is explained in part by a 20% to 40% higher rate of sympathetic nerve discharge in lean black men compared with lean white men and lean black and white women (28Ϯ3 versus 18Ϯ2, 21Ϯ2, and 17Ϯ2 bursts/min, respectively; PϽ0.05). Sympathetic nerve discharge in lean black men is comparable to that of overweight black men and women as well as white men and women. These data provide the first microneurographic evidence for tonic central sympathetic overactivity in blacks, both adiposity-related sympathetic overactivity in black women and adiposity-independent sympathetic overactivity in black men. Key Words: obesity Ⅲ sympathetic nervous system Ⅲ blacks Ⅲ blood pressure O besity is firmly established to be a major risk factor for hypertension, and a large body of clinical investigation implicates an important role for the sympathetic nervous system in linking adiposity with hypertension. [1][2][3][4][5][6] In numerous studies of normotensive young adults, increasing adiposity is accompanied by increased sympathetic nerve discharge (SND) to skeletal muscle, a major site of energy expenditure. 5-7 Overweight-related sympathetic overactivity is hypothesized to be a compensatory mechanism to burn fat and minimize weight gain but at the cost of increased sympathetic discharge to the peripheral vasculature, which could predispose to hypertension. 2,8 However, the experimental support for this hypothesis is derived from strictly white cohorts. 5,6 The importance of inclusion of minority subjects in this field of clinical investigation is underscored by recent studies of Pima Indians, an ethnic minority with a high prevalence of obesity but a comparatively low prevalence of hypertension. 4 Basal levels of skeletal muscle SND are lower in normotensive male Pima Indians than in whites and do not track with adiposity. This relative sympathetic underactivity constitutes a potential explanation for the surprisingly low prevalence of hypertensio...

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Obesity and hypertension in a longitudinal study of black physicians: The Meharry Cohort Study

Cited by 48 publications

References 17 publications

Hypertension and its determinants among adults in high mountain villages of the Northern Areas of Pakistan

Hypertension and its determinants among adults in high mountain villages of the Northern Areas of Pakistan

Physicians recommendations for and personal use of low-fat and low-carbohydrate diets

Overweight and Sympathetic Overactivity in Black Americans

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