High Blood Pressure Common in the Overweight and Obese

Obese patients often have increased ambulatory blood pressure as well as an altered circadian blood pressure rhythm. Also, with many failing to experience a nighttime dip in blood pressure as occurs in normal weight individuals.

These are the findings of Dr. Vasilios Kotsis from the University of Mississippi Medical Center in Jackson and colleagues who studied the relationship between BMI and various parameters of ambulatory blood pressure in 3216 outpatients visiting a hypertension clinic who had never been treated with antihypertensive drugs.

Thirty-five patients were underweight (BMI less than 18.49),1,057 were normal weight (BMI,18.5 to 24.9), 1,299 were overweight (BMI 25 to 29.9), and 825 were obese (BMI greater than 30).

BMI correlated significantly and positively with clinic systolic and diastolic blood pressure, the team reports in the April issue of Hypertension: Journal of the American Heart Association.

Moreover, "obese individuals had increased 24-hour, daytime and nighttime blood pressure levels compared to non-obese individuals." Overweight and obese individuals were also less likely to experience a nighttime dip in blood pressure.

Confirming prior studies, the incidence of white coat and ambulatory blood pressure hypertension was also higher in overweight and obese subjects compared with normal weight subjects.

Dr. Kotsis noted that, obesity-induced hypertension is "one of the most significant comorbidities of obesity,"

"Primary care doctors must focus on obesity-induced hypertension in order to prevent future cardiovascular complications such as heart failure in their obese patients. Body weight reduction, lifestyle modifications and antihypertensive treatment could reduce obese patients’ cardiovascular risk," he said.
Hypertension 2005;45:602-607.