This site complies with the HONcode standard for trustworthy health information:
verify here.

Rewarding for
you and us
Defeat Diabetes Foundation

Defeat Diabetes
Foundation
150 153rd Ave,
Suite 300
Madeira Beach, FL 33708

The Obesity Paradox -- Fatter is Better for Hypertensive CAD Patients?

Posted: Thursday, November 29, 2007

New study findings -The obesity paradox -- an unexpected decrease in morbidity and mortality with increasing BMI, which has been described in patients with heart failure and those undergoing percutaneous coronary intervention -- exists in patients with hypertension and coronary artery disease (CAD) as well.

In the October issue of the American Journal of Medicine, Dr. Seth Uretsky from St. Luke's-Roosevelt Hospital in New York City and colleagues write, “The reasons for the apparent protective effect of increased BMI in these populations "are unclear."

They investigated the effect of overweight and obesity on cardiovascular outcomes in 22,576 treated hypertensive patients with known coronary artery disease who participated in a large prospective randomized treatment trial.

Compared to normal-weight patients (BMI 20 to 25), the risk of the primary outcome of death, MI, or stroke was lower in patients who were overweight (BMI 25 to 30), and in those with class I obesity (BMI 30 to 35) and class II-III obesity (BMI 35 or greater).

Compared to a normal BMI, the adjusted hazard ratios for the three higher BMI classes were 0.77, 0.68, and 0.76, respectively, "driven primarily" by a decreased risk of all-cause mortality.

"This 'obesity paradox' occurred in men and women across all age groups, even though blood pressure was better controlled in normal-weight patients," the investigators note.

In a commentary, Dr. Carl J. Lavie and colleagues of the Ochsner Medical Center, New Orleans caution that while improved outcomes appear to be consistently associated with increased BMI, "one should not conclude that weight reduction is detrimental in overweight populations."

Results of numerous studies, they point out, clearly support the benefits of "purposeful weight reduction" in obese patients with heart disease, despite the obesity paradox.

"As we continue to investigate the obesity paradox in cardiovascular disease ... we should remember the old proverb, "Only one thing is certain - that is nothing is certain," Dr. Lavie and colleagues advise.

Source: Diabetes In Control: Am J Med 2007;120:825-826,863-870.