Weight Loss As Treatment For Hypertension
Treatment of hypertension can be divided into a pharmacological and a nonpharmacological component. The latter can be described as a series of lifestyle changes such as weight reduction, physical activity, low sodium intake, moderation of alcohol intake, cessation of smoking, and stress management. In a study by Andrews et al. ), of nonpharmacological treatments, weight reduction was more effective compared to yoga, muscle relaxation, exercise training, blood pressure biofeedback, and salt restriction. In the obese hypertensive patient, weight loss should be included as a component of a comprehensive lifestyle treatment program, including physical activity and salt restriction. In addition, weight loss has a beneficial effect on other cardiovascular risk factors often present in obese hypertensive individuals such as lipid disturbances , , ), insulin resistance , ), and disturbances in the hemostatic and fibrinolytic system ). It also improves psychological well-being and overall quality of life ).
If a nonpharmacological treatment is adequate enough to normalize blood pressure values, the cost and the potential known or unknown adverse affects of drug therapy can be avoided ). In contrast with some blood pressure-lowering drugs such as thiazide diuretic agents ), weight loss has an additional positive effect on plasma lipoproteins and insulin sensitivity ).
The Role Of Metabolic Surgery In The Treatment Of Obesity
Metabolic surgery encompasses some of the fastest-growing gastrointestinal procedures worldwide. According to the latest International Federation for the Surgery of Obesity and Metabolic Disorders survey, an estimated > 680,000 metabolic procedures were performed across the globe in 2016 , which was double the number of cases reported in 2011 . Metabolic procedures currently performed in the US include sleeve gastrectomy Roux-en-Y gastric bypass adjustable gastric banding and biliopancreatic diversion with duodenal switch .
Renal And Adrenal Mechanisms
Obesity-related hypertension is associated with renal sodium retention and impaired pressure natriuresis. Obese humans and subjects with the metabolic syndrome tend to be relatively salt sensitive., Increased renal tubular reabsorption of sodium has been attributed to increased sympathetic outflow to the kidney. In the dog, renal denervation blunts sodium retention and attenuates the rise in blood pressure associated with dietary-induced obesity. It has also been suggested that increased intrarenal pressures caused by fat surrounding the kidneys and increased abdominal pressure associated with visceral obesity may impair natriuresis.
Although not as potent a mineralocorticoid as aldosterone, in high concentrations, cortisol may increase arterial pressure by activating the mineralocorticoid receptor. Circulating levels of cortisol are variable in obesity however, they may not reflect cortisol’s activity in target tissues. 11-Hydroxysteroid dehydrogenase type 1 activates cortisone to cortisol in target tissues, including adipose tissue. This conversion is more pronounced in visceral than in subcutaneous adipose tissue. The P2-HSD1 mouse with overexpression of HSD1 develops hypertension, features of the clinical metabolic syndrome, and activation of the circulating reninangiotensinaldosterone system. Although these observations are provocative, a role for cortisol in the pathogenesis of obesity-related hypertension and the metabolic syndrome remains to be established.
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Obesity And Heart Disease: Whats The Connection
Heres the inside story on how and why being overweight or obese can increase your risk of having heart problems.
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Its a known fact that obesity can take a toll on your heart health. And theres a plethora of research to back it up. For instance, a recent study published in April 2018 in the journal JAMA Cardiology concluded that adults between ages 40 and 59 who are overweight or obese have a significantly increased risk of developing cardiovascular disease as compared with their normal weight peers. Individuals who are overweight, defined as having a body mass index between 25 and 29.9, or are obese , also have a much greater risk of developing cardiovascular disease at a younger age. The research showed that individuals who are obese had a shorter lifespan.
The link between heart disease and obesity is multifaceted. For one thing, obesity increases your risk of developing many other risk factors for heart disease. It also triggers inflammatory processes that can harm your cardiovascular system, and it can lead to structural or functional changes in the heart itself. Read on for the details.
What Blood Pressure Is Considered Too High
A blood pressure of 130/80 or higher is considered high. This is called hypertension
A blood pressure between 120 and 129 and less than 80 is considered elevated. This means that you do not have hypertension, but you may develop it in the future unless you adopt lifestyle changes to keep your blood pressure under control.
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Good Weight And Measure Are Heaven’s Treasure
Excess body weight is the sixth most important risk factor contributing to the overall burden of disease worldwide . More than 1 billion adults and 10% of children are now classified as overweight or obese . In the USA, obesity is set to overtake smoking in 2005 as the main preventable cause of illness and premature death .
Obesity and in particular central obesity have been consistently associated with hypertension and increased cardiovascular risk. Based on population studies, risk estimates indicate that at least two-thirds of the prevalence of hypertension can be directly attributed to obesity . Apart from hypertension, abdominal adiposity has also been implicated in the pathogenesis of coronary artery disease, sleep apnoea, stroke and congestive heart failure .
Fig. 1.
Prevalence of microalbuminuria according to body mass index in the PREVEND study .
Given the close link between obesity and cardiovascular disease, it has been suggested that current trends in obesity might lead to a decline of the life expectancy in the USA in the 21st century . Similar trends are likely to occur in other countries.
Comprehensive Health Care In Sherman Texas
If you would like to learn more about the links between hypertension and obesity, contact Carrus Health. Our aim is to deliver exceptional comprehensive medical care, in a caring and relaxed atmosphere, for our patients and their families through all stages of life. For more information about our primary care services, call us today at .
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Obesity: A World Disease
In the world, obesity rages like an epidemic that involves millions of people each year. The World Health Organization has declared that around 39% of the worlds population is overweight and that worldwide obesity has nearly tripled since 1975. This alarming evidence shows that obesity is one of the major public health problems of the twenty-first century and the most frequent nutritional disorder in the developed countries. The infants with excess weight, in 2016, were 41 million. This problem mainly concerns the urban zone of developing countries.1
The prevalence of people with excess weight in Europe differs among countries: in the Mediterranean area it ranges from 20 to 40%, and in the northern countries it lies between 10 and 20% . These figures are alarming, especially when one considers that Mediterranean countries, which are traditionally supposed to follow a Mediterranean diet, classified as a healthy food regime, have the highest prevalence of overweight children. In 2015 in Italy, children and adolescents in excess of weight reached a proportion of 30.6%.2
Childhood overweight is a very common problem in high-income countries, but it has also spread in medium and low-income areas, and it is mostly due to low-quality diet and poor physical activity .
There are, therefore, several factors contributing to the onset of overweight besides, genetic predisposition, socio-environmental, and psychological factors also contribute .
Does Obesity Increase Dementia Risk
Obesity, or having excess body fat, is a known risk factor for dementia. But new research indicates the risk level depends on where the fat is stored on the body, and that it may be time to swap out the scale for a tape measure.
Obesity during middle age, generally 40 to 60 years old, has consistently been associated with a higher risk of dementia later in life. However, reports of whether excess fat is helpful or harmful for the cognitive function of adults over age 65 have varied. The conflicting results can be explained by the way obesity has been measured in prior studies , according to new evidence from a recent population study examining the relationship between obesity and cognitive function in more than 5000 people over age 60. This study suggests that dementia risk is most associated with central obesity, or having excess belly fat.
The body mass index is the most commonly used measure of overall obesity, or overall level of body fat. It is based on the relationship between height and weight. BMI is calculated according to the formula: BMI = weight ÷ height × 703. A BMI between 18.5-25 is considered healthy, while greater than 25 is overweight, and greater than 30 is considered obese . For a 6-foot-tall man, a weight of 170 lbs. would result in a healthy BMI of 23, whereas at a weight of 270 lbs. and corresponding BMI of 37, the man would be defined as obese.
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How To Lower Your Risk
Losing as little as 5 percent of your body weight can lower your risk for several of these health conditions, including heart disease and type 2 diabetes.
A combination of diet and exercise can help you lose the weight slowly over time. Theres no need to make drastic changes to your lifestyle. The key is to be consistent and to continue making healthy choices.
For exercise, aim for at least 150 minutes a week of moderate aerobic activity. This can include a brisk walk just 30 minutes of walking per day will help you meet this goal. Once youve gotten the hang of it, try increasing your exercise to 300 minutes per week. Also, try to include strengthening activities like pushups or situps into your routine at least twice a week.
A few ways to eat healthier include:
- Fill half your plate with vegetables.
- Replace unrefined grains, like white bread, pasta, and rice with whole grains like whole wheat bread, brown rice, and oatmeal.
- Eat lean sources of protein, such as lean chicken, seafood, beans, and soy.
- Cut out fried foods, fast foods, and sugary snacks.
- Avoid sugary drinks, like sodas and juice.
- Avoid alcohol.
Ask your doctor if youre a good candidate for weight loss surgery or medications. These treatments can help you lose weight more quickly, but still require a commitment to the above lifestyle changes.
How Much Alcohol Can I Drink If I Have High Blood Pressure
Drinking too much alcohol can raise your blood pressure. It may also lead to the development of high blood pressure. So to help prevent high blood pressure, if you drink alcohol, limit how much you drink to no more than two drinks a day if you are male. The “Dietary Guidelines for Americans” recommend that for overall health, women and lighter weight persons should limit their alcohol to no more than one drink a day.
This is what counts as a drink:
- 1 1/2 ounces of 80-proof or 1 ounce of 100-proof whiskey
- 5 ounces of wine
- 12 ounces of beer
You may have heard that some alcohol is good for your heart. Some studies suggest that people who consume a drink or two a day have lower blood pressure and live longer than those who consume excessive amounts of alcohol or no alcohol at all. Others note that wine raises the “good” blood cholesterol that prevents the build-up of fats in the arteries.
While these studies may be correct, they don’t tell the whole story. Too much alcohol contributes to a host of other health problems, such as motor vehicle accidents, diseases of the liver and pancreas, damage to the brain and heart, an increased risk of many cancers, and fetal alcohol syndrome. Alcohol is also high in calories. So you should limit how much you drink.
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Hypertension And Obesity: How Weight
Winter 2009
It is important to get both weight and hypertension under control to be healthy both hypertension and obesity are major health issues in the United States.
The Incidence of Hypertension and Obesity
The Framingham Heart Study, a famous study for 44 years, estimated that excess body weight , accounted for approximately 26 percent of cases of hypertension in men and 28 percent in women, and for approximately 23 percent of cases of coronary heart disease in men and 15 percent in women. Individuals with obesity have an increase in fatty tissue that increases their vascular resistance and in turn increases the work the heart has to do to pump blood throughout the body .
What is Hypertension?
Hypertension refers to the pressure that blood applies to the inner walls of the arteries. The diagnosis of high blood pressure cannot be given if the patient is ill or is already on blood pressure medicines.
High blood pressure is based on the average of two or more properly measured blood pressure readings at each of two or more visits after an initial screening. The definitions are based on The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report .
Physicians use the following classifications:
- Normal blood pressure: systolic equal to or less than 120 mmHg and diastolic equal to or less than 80 mmHg
- Pre-hypertension: systolic 120-139 mmHg or diastolic 80-89 mmHg
Types of Hypertension
Obesity Depression And Quality Of Life
The high rates of obesity and depression, and their individual links with cardiovascular disease, have prompted many investigators to explore the relationship between weight and mood. An analysis of 17 cross-sectional studies found that people who were obese were more likely to have depression than people with healthy weights. Since the studies included in the analysis assessed weight and mood only at one point in time, the investigators could not say whether obesity increases the risk of depression or depression increases the risk of obesity. New evidence confirms that the relationship between obesity and depression may be a two-way street: A meta-analysis of 15 long-term studies that followed 58,000 participants for up to 28 years found that people who were obese at the start of the study had a 55 percent higher risk of developing depression by the end of the follow-up period, and people who had depression at the start of the study had a 58 percent higher risk of becoming obese.
Although a biological link between obesity and depression has not yet been definitively identified, possible mechanisms include activation of inflammation, changes in the hypothalamic-pituitary-adrenal axis, insulin resistance, and social or cultural factors.
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Available Treatments For Obesity
In clinical studies, weight loss of around 510% can result in a reduced risk of T2D and cardiovascular disease. Anti-obesity medications increase the likelihood of achieving clinically meaningful weight loss when used as an adjunct to lifestyle intervention. Pharmacological intervention as adjunct to diet and exercise is indicated for individuals with a BMI30 or27 kg/m2 with at least one obesity-related comorbidity.
The available treatments, currently approved by FDA, EMA and in Brazil, and clinical trials outcomes are described below and summarized in Table .
Table 1 Clinical trials outcomes studies for anti-obesity agents
Obesity And Cardiovascular Disease
Body weight is directly associated with various cardiovascular risk factors. As BMI increases, so do blood pressure, low-density lipoprotein cholesterol, triglycerides, blood sugar, and inflammation. These changes translate into increased risk for coronary heart disease, stroke, and cardiovascular death:
- Obesity and Coronary Artery Disease. Numerous studies have demonstrated a direct association between excess body weight and coronary artery disease . The BMI-CAD Collaboration Investigators conducted a meta-analysis of 21 long-term studies that followed more than 300,000 participants for an average of 16 years. Study participants who were overweight had a 32 percent higher risk of developing CAD, compared with participants who were at a normal weight those who were obese had an 81 percent higher risk. Although adjustment for blood pressure and cholesterol levels slightly lowered the risk estimates, they remained highly significant for obesity. The investigators estimated that the effect of excess weight on blood pressure and blood cholesterol accounts for only about half of the obesity-related increased risk of coronary heart disease.
The good news is that weight loss of 5 to 10 percent of body weight can lower blood pressure, LDL cholesterol, and triglycerides, and improve other cardiovascular risk factors.
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The Link Between Obesity And Diabetes
December 26, 2017 by Diabetes Care
Most people have heard that there is a link between obesity and diabetes. The reality is that being obese or even overweight can increase your chances of developing type 2 diabetes.
According to the Canadian Obesity Network, one in four Canadian adults and one in 10 children have clinical obesity. Research also shows that if youre obese, your chances of developing type 2 diabetes are 80 times greater than those of people whose body mass index is within a normal range .
Healthy Lifestyle Changes To Prevent Overweight And Obesity
If your BMI indicates you are getting close to being overweight, or if you have certain risk factors, your doctor may recommend you adopt healthy lifestyle changes to prevent you from becoming overweight and obese. Changes include healthy eating, being physically active, aiming for a healthy weight, and getting healthy amounts of sleep. Read healthy lifestyle changes for more information
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Rapid Effects Of A High
When the researchers fed mice a high-fat, high-sugar diet, they found increased growth of blood vessels in the animals hypothalamus just 2 weeks later.
This blood vessel growth coincided with weight gain and raised blood levels of leptin, a hormone produced by fat tissue to help regulate long-term food intake.
In further experiments, the researchers used mice that they genetically engineered to have obesity but no leptin. Despite having obesity, these mice did not show any vascular changes in the hypothalamus. Therefore, the researchers suggest that leptin is the key player in mediating vascular changes.
However, when the scientists injected the mice with leptin, the animals lost weight and sprouted more hypothalamic blood vessels.
In further experiments, the researchers showed that star-shaped cells in the hypothalamus called astrocytes mediated this effect.
are support cells that interact with both neurons and blood vessels at the blood-brain barrier.
Leptin induced the cells to produce vascular endothelial growth factor and stimulate blood vessel growth.
Crucially, VEGF and the overgrowth of blood vessels in this part of the brain appeared to trigger increased blood pressure in obese mice.
The study appears in the journal