nach oben

Current Cardiology Reports

Erschienen in:

01.10.2017 | Hypertension (DS Geller and DL Cohen, Section Editors)

Hypertension in Obesity and the Impact of Weight Loss

verfasst von: Jordana B. Cohen

Erschienen in: Current Cardiology Reports | Ausgabe 10/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Several interrelated mechanisms promote the development of hypertension in obesity, often contributing to end organ damage including cardiovascular disease and chronic kidney disease.

Recent Findings

The treatment of hypertension in obesity is complicated by a high prevalence of resistant hypertension, as well as unpredictable hemodynamic effects of many medications. Weight loss stabilizes neurohormonal activity and causes clinically significant reductions in blood pressure. While lifestyle interventions can improve blood pressure, they fail to consistently yield sustained weight loss and have not demonstrated long-term benefits. Bariatric surgery provides more permanent weight reduction, corresponding with dramatic declines in blood pressure and attenuation of long-term cardiovascular risk.

Summary

Hypertension is closely linked to the prevalence, pathophysiology, and morbidity of obesity. There are multiple barriers to managing hypertension in obesity. Surgical weight loss offers the most promise in reducing blood pressure and decreasing end organ damage in this patient population.

•• The GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017; doi:10.1056/NEJMoa1614362. This systematic review of epidemiologic evidence evaluated trends in obesity across 195 countries, evaluating the global impact of obesity on mortality and disability. Unlike previous studies, these analyses addressed important issues including the relationship between BMI and economic development and the influence of epidemiologic and demographic transition on disease burden in obesity.

Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016;315(21):2284–91. doi:10.1001/jama.2016.6458.PubMedCrossRef

Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002;288(14):1723–7. doi:10.1001/jama.288.14.1723.PubMedCrossRef

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014;384(9945):766–81. doi:10.1016/S0140-6736(14)60460-8.PubMedPubMedCentralCrossRef

Wormser D, Kaptoge S, Di Angelantonio E, Wood AM, Pennells L, Thompson A, et al. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet. 2011;377(9771):1085–95. doi:10.1016/S0140-6736(11)60105-0.PubMedCrossRef

Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation. 2007;116(1):39–48. doi:10.1161/CIRCULATIONAHA.106.675355.PubMedCrossRef

Hsu CY, McCulloch CE, Iribarren C, Darbinian J, Go AS. Body mass index and risk for end-stage renal disease. Ann Intern Med. 2006;144(1):21–8.PubMedCrossRef

Loef M, Walach H. Midlife obesity and dementia: meta-analysis and adjusted forecast of dementia prevalence in the United States and China. Obesity (Silver Spring). 2013;21(1):E51–5. doi:10.1002/oby.20037.CrossRef

Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K, et al. Body fatness and cancer—viewpoint of the IARC Working Group. N Engl J Med. 2016;375(8):794–8. doi:10.1056/NEJMsr1606602.PubMedCrossRef

10.

Arnold M, Leitzmann M, Freisling H, Bray F, Romieu I, Renehan A, et al. Obesity and cancer: an update of the global impact. Cancer Epidemiol. 2016;41:8–15. doi:10.1016/j.canep.2016.01.003.PubMedCrossRef

11.

Al Rifai M, Silverman MG, Nasir K, Budoff MJ, Blankstein R, Szklo M, et al. The association of nonalcoholic fatty liver disease, obesity, and metabolic syndrome, with systemic inflammation and subclinical atherosclerosis: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis. 2015;239(2):629–33. doi:10.1016/j.atherosclerosis.2015.02.011.PubMedPubMedCentralCrossRef

12.

Malhotra A, White DP. Obstructive sleep apnoea. Lancet. 2002;360(9328):237–45. doi:10.1016/S0140-6736(02)09464-3.PubMedCrossRef

13.

Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309(1):71–82. doi:10.1001/jama.2012.113905.PubMedPubMedCentralCrossRef

14.

Aune D, Sen A, Prasad M, Norat T, Janszky I, Tonstad S et al. BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants. Br Med J. 2016; 353. doi:ARTN10.1136/bmj.i2156.

15.

Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146–603. doi:10.1161/CIR.0000000000000485.PubMedPubMedCentralCrossRef

16.

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60. doi:10.1016/S0140-6736(12)61766-8.PubMedPubMedCentralCrossRef

17.

Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88. doi:10.1186/1471-2458-9-88.PubMedPubMedCentralCrossRef

18.

Garrison RJ, Kannel WB, Stokes J 3rd, Castelli WP. Incidence and precursors of hypertension in young adults: the Framingham Offspring study. Prev Med. 1987;16(2):235–51.PubMedCrossRef

19.

Shihab HM, Meoni LA, Chu AY, Wang NY, Ford DE, Liang KY, et al. Body mass index and risk of incident hypertension over the life course: the Johns Hopkins Precursors Study. Circulation. 2012;126(25):2983–9. doi:10.1161/CIRCULATIONAHA.112.117333.PubMedPubMedCentralCrossRef

20.

Egan BM, Li J, Hutchison FN, Ferdinand KC. Hypertension in the United States, 1999 to 2012: progress toward healthy people 2020 goals. Circulation. 2014;130(19):1692–9. doi:10.1161/CIRCULATIONAHA.114.010676.PubMedPubMedCentralCrossRef

21.

Saydah S, Bullard KM, Cheng Y, Ali MK, Gregg EW, Geiss L, et al. Trends in cardiovascular disease risk factors by obesity level in adults in the United States, NHANES 1999-2010. Obesity (Silver Spring). 2014;22(8):1888–95. doi:10.1002/oby.20761.CrossRef

22.

Fonseca-Reyes S, de Alba-Garcia JG, Parra-Carrillo JZ, Paczka-Zapata JA. Effect of standard cuff on blood pressure readings in patients with obese arms. How frequent are arms of a ‘large circumference’? Blood Press Monit. 2003;8(3):101–6. doi:10.1097/01.mbp.0000085763.28312.03.PubMedCrossRef

23.

Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clin Pharmacokinet. 2010;49(2):71–87. doi:10.2165/11318100-000000000-00000.PubMedCrossRef

24.

Sironi AM, Gastaldelli A, Mari A, Ciociaro D, Positano V, Buzzigoli E, et al. Visceral fat in hypertension: influence on insulin resistance and beta-cell function. Hypertension. 2004;44(2):127–33. doi:10.1161/01.HYP.0000137982.10191.0a.PubMedCrossRef

25.

Cox AJ, West NP, Cripps AW. Obesity, inflammation, and the gut microbiota. Lancet Diabetes Endocrinol. 2015;3(3):207–15. doi:10.1016/S2213-8587(14)70134-2.PubMedCrossRef

26.

Furukawa S, Fujita T, Shimabukuro M, Iwaki M, Yamada Y, Nakajima Y, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest. 2004;114(12):1752–61. doi:10.1172/JCI21625.PubMedPubMedCentralCrossRef

27.

• Huby AC, Antonova G, Groenendyk J, Gomez-Sanchez CE, Bollag WB, Filosa JA et al. The adipocyte-derived hormone leptin is a direct regulator of aldosterone secretion, which promotes endothelial dysfunction and cardiac fibrosis. Circulation. 2015. doi:10.1161/CIRCULATIONAHA.115.018226. This in vitro study evaluating human adrenal tissue demonstrated that leptin acts directly on adrenal glomerulus cells to stimulate aldosterone production and pro-fibrotic cardiac markers. Anti-mineralocorticoid administration was effective in attenuating aldosterone secretion as well as the pro-fibrotic markers.

28.

Buglioni A, Cannone V, Cataliotti A, Sangaralingham SJ, Heublein DM, Scott CG, et al. Circulating aldosterone and natriuretic peptides in the general community: relationship to cardiorenal and metabolic disease. Hypertension. 2015;65(1):45–53. doi:10.1161/HYPERTENSIONAHA.114.03936.PubMedCrossRef

29.

Gamez-Mendez AM, Vargas-Robles H, Rios A, Escalante B. Oxidative stress-dependent coronary endothelial dysfunction in obese mice. PLoS One. 2015;10(9):e0138609. doi:10.1371/journal.pone.0138609.PubMedPubMedCentralCrossRef

30.

Moreno-Navarrete JM, Sabater M, Ortega F, Ricart W, Fernandez-Real JM. Circulating zonulin, a marker of intestinal permeability, is increased in association with obesity-associated insulin resistance. PLoS One. 2012;7(5):e37160. doi:10.1371/journal.pone.0037160.PubMedPubMedCentralCrossRef

31.

Holst AG, Jensen G, Prescott E. Risk factors for venous thromboembolism: results from the Copenhagen City Heart Study. Circulation. 2010;121(17):1896–903. doi:10.1161/CIRCULATIONAHA.109.921460.PubMedCrossRef

32.

Caillon A, Schiffrin EL. Role of inflammation and immunity in hypertension: recent epidemiological, laboratory, and clinical evidence. Curr Hypertens Rep. 2016;18(3):21. doi:10.1007/s11906-016-0628-7.PubMedCrossRef

33.

Lohmeier TE, Iliescu R. The sympathetic nervous system in obesity hypertension. Curr Hypertens Rep. 2013;15(4):409–16. doi:10.1007/s11906-013-0356-1.PubMedPubMedCentralCrossRef

34.

Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342(19):1378–84. doi:10.1056/NEJM200005113421901.PubMedCrossRef

35.

Zhuo JL, Li XC. New insights and perspectives on intrarenal renin-angiotensin system: focus on intracrine/intracellular angiotensin II. Peptides. 2011;32(7):1551–65. doi:10.1016/j.peptides.2011.05.012.PubMedPubMedCentralCrossRef

36.

Cassis LA, Police SB, Yiannikouris F, Thatcher SE. Local adipose tissue renin-angiotensin system. Curr Hypertens Rep. 2008;10(2):93–8.PubMedPubMedCentralCrossRef

37.

Burke GL, Bertoni AG, Shea S, Tracy R, Watson KE, Blumenthal RS, et al. The impact of obesity on cardiovascular disease risk factors and subclinical vascular disease: the Multi-Ethnic Study of Atherosclerosis. Arch Intern Med. 2008;168(9):928–35. doi:10.1001/archinte.168.9.928.PubMedPubMedCentralCrossRef

38.

Wohlfahrt P, Somers VK, Cifkova R, Filipovsky J, Seidlerova J, Krajcoviechova A, et al. Relationship between measures of central and general adiposity with aortic stiffness in the general population. Atherosclerosis. 2014;235(2):625–31. doi:10.1016/j.atherosclerosis.2014.05.958.PubMedCrossRef

39.

Brunner EJ, Shipley MJ, Ahmadi-Abhari S, Tabak AG, McEniery CM, Wilkinson IB, et al. Adiposity, obesity, and arterial aging: longitudinal study of aortic stiffness in the Whitehall II cohort. Hypertension. 2015;66(2):294–300. doi:10.1161/HYPERTENSIONAHA.115.05494.PubMedPubMedCentralCrossRef

40.

Boillot A, Zoungas S, Mitchell P, Klein R, Klein B, Ikram MK, et al. Obesity and the microvasculature: a systematic review and meta-analysis. PLoS One. 2013;8(2):e52708. doi:10.1371/journal.pone.0052708.PubMedPubMedCentralCrossRef

41.

Amann K, Benz K. Structural renal changes in obesity and diabetes. Semin Nephrol. 2013;33(1):23–33. doi:10.1016/j.semnephrol.2012.12.003.PubMedCrossRef

42.

Cuspidi C, Rescaldani M, Sala C, Grassi G. Left-ventricular hypertrophy and obesity: a systematic review and meta-analysis of echocardiographic studies. J Hypertens. 2014;32(1):16–25. doi:10.1097/HJH.0b013e328364fb58.PubMedCrossRef

43.

McTigue KM, Chang YF, Eaton C, Garcia L, Johnson KC, Lewis CE, et al. Severe obesity, heart disease, and death among white, African American, and Hispanic postmenopausal women. Obesity (Silver Spring). 2014;22(3):801–10. doi:10.1002/oby.20224.CrossRef

44.

Hollenstein UM, Brunner M, Schmid R, Muller M. Soft tissue concentrations of ciprofloxacin in obese and lean subjects following weight-adjusted dosing. Int J Obes Relat Metab Disord. 2001;25(3):354–8. doi:10.1038/sj.ijo.0801555.PubMedCrossRef

45.

Zuckerman M, Greller HA, Babu KM. A review of the toxicologic implications of obesity. J Med Toxicol. 2015;11(3):342–54. doi:10.1007/s13181-015-0488-6.PubMedPubMedCentralCrossRef

46.

Farrell GC, Teoh NC, McCuskey RS. Hepatic microcirculation in fatty liver disease. Anat Rec (Hoboken). 2008;291(6):684–92. doi:10.1002/ar.20715.CrossRef

47.

Brill MJ, van Rongen A, Houwink AP, Burggraaf J, van Ramshorst B, Wiezer RJ, et al. Midazolam pharmacokinetics in morbidly obese patients following semi-simultaneous oral and intravenous administration: a comparison with healthy volunteers. Clin Pharmacokinet. 2014;53(10):931–41. doi:10.1007/s40262-014-0166-x.PubMedPubMedCentralCrossRef

48.

Brill MJ, Diepstraten J, van Rongen A, van Kralingen S, van den Anker JN, Knibbe CA. Impact of obesity on drug metabolism and elimination in adults and children. Clin Pharmacokinet. 2012;51(5):277–304. doi:10.2165/11599410-000000000-00000.PubMedCrossRef

49.

Bouquegneau A, Vidal-Petiot E, Vrtovsnik F, Cavalier E, Rorive M, Krzesinski JM, et al. Modification of diet in renal disease versus chronic kidney disease epidemiology collaboration equation to estimate glomerular filtration rate in obese patients. Nephrol Dial Transplant. 2013;28 Suppl 4(suppl 4):iv122–iv30. doi:10.1093/ndt/gft329.PubMed

50.

Sinkeler SJ, Visser FW, Krikken JA, Stegeman CA, Homan van der Heide JJ, Navis G. Higher body mass index is associated with higher fractional creatinine excretion in healthy subjects. Nephrol Dial Transplant 2011; 26 (10):3181–3188. doi:10.1093/ndt/gfq850.

51.

Ahmed SB, Fisher ND, Stevanovic R, Hollenberg NK. Body mass index and angiotensin-dependent control of the renal circulation in healthy humans. Hypertension. 2005;46(6):1316–20. doi:10.1161/01.HYP.0000190819.07663.da.PubMedCrossRef

52.

Wojcicki J, Jaroszynska M, Drozdzik M, Pawlik A, Gawronska-Szklarz B, Sterna R. Comparative pharmacokinetics and pharmacodynamics of propranolol and atenolol in normolipaemic and hyperlipidaemic obese subjects. Biopharm Drug Dispos. 2003;24(5):211–8. doi:10.1002/bdd.357.PubMedCrossRef

53.

Wofford MR, Anderson DC Jr, Brown CA, Jones DW, Miller ME, Hall JE. Antihypertensive effect of alpha- and beta-adrenergic blockade in obese and lean hypertensive subjects. Am J Hypertens. 2001;14(7 Pt 1):694–8.PubMedCrossRef

54.

Cohen JB, Stephens-Shields AJ, Denburg MR, Anderson AH, Townsend RR, Reese PP. Obesity, renin-angiotensin system blockade and risk of adverse renal outcomes: a population-based cohort study. Am J Nephrol. 2016;43(6):431–40. doi:10.1159/000446862.PubMedPubMedCentralCrossRef

55.

Raij L, Egan BM, Zappe DH, Purkayastha D, Samuel R, Sowers JR. Office and ambulatory blood pressure-lowering effects of combination valsartan/hydrochlorothiazide vs. hydrochlorothiazide-based therapy in obese, hypertensive patients. J Clin Hypertens (Greenwich). 2011;13(10):731–8. doi:10.1111/j.1751-7176.2011.00499.x.CrossRef

56.

Schmieder RE, Philipp T, Guerediaga J, Gorostidi M, Bush C, Keefe DL. Aliskiren-based therapy lowers blood pressure more effectively than hydrochlorothiazide-based therapy in obese patients with hypertension: sub-analysis of a 52-week, randomized, double-blind trial. J Hypertens. 2009;27(7):1493–501. doi:10.1097/HJH.0b013e32832be593.PubMedCrossRef

57.

Reisin E, Graves JW, Yamal JM, Barzilay JI, Pressel SL, Einhorn PT, et al. Blood pressure control and cardiovascular outcomes in normal-weight, overweight, and obese hypertensive patients treated with three different antihypertensives in ALLHAT. J Hypertens. 2014;32(7):1503–1513; discussion 13. doi:10.1097/HJH.0000000000000204.PubMedPubMedCentralCrossRef

58.

Bianchi S, Bigazzi R, Campese VM. Long-term effects of spironolactone on proteinuria and kidney function in patients with chronic kidney disease. Kidney Int. 2006;70(12):2116–23. doi:10.1038/sj.ki.5001854.PubMedCrossRef

59.

Bakris GL, Agarwal R, Chan JC, Cooper ME, Gansevoort RT, Haller H, et al. Effect of finerenone on albuminuria in patients with diabetic nephropathy: a randomized clinical trial. JAMA. 2015;314(9):884–94. doi:10.1001/jama.2015.10081.PubMedCrossRef

60.

Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized aldactone evaluation study investigators. N Engl J Med. 1999;341(10):709–17. doi:10.1056/NEJM199909023411001.PubMedCrossRef

61.

Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003;348(14):1309–21. doi:10.1056/NEJMoa030207.PubMedCrossRef

62.

Hwang MH, Yoo JK, Luttrell M, Kim HK, Meade TH, English M, et al. Mineralocorticoid receptors modulate vascular endothelial function in human obesity. Clin Sci (Lond). 2013;125(11):513–20. doi:10.1042/CS20130200.CrossRef

63.

Garg R, Kneen L, Williams GH, Adler GK. Effect of mineralocorticoid receptor antagonist on insulin resistance and endothelial function in obese subjects. Diabetes Obes Metab. 2014;16(3):268–72. doi:10.1111/dom.12224.PubMedCrossRef

64.

Bender SB, DeMarco VG, Padilla J, Jenkins NT, Habibi J, Garro M, et al. Mineralocorticoid receptor antagonism treats obesity-associated cardiac diastolic dysfunction. Hypertension. 2015;65(5):1082–8. doi:10.1161/HYPERTENSIONAHA.114.04912.PubMedPubMedCentralCrossRef

65.

Youcef G, Olivier A, Nicot N, Muller A, Deng C, Labat C, et al. Preventive and chronic mineralocorticoid receptor antagonism is highly beneficial in obese SHHF rats. Br J Pharmacol. 2016;173(11):1805–19. doi:10.1111/bph.13479.PubMedPubMedCentralCrossRef

66.

Nagase M, Yoshida S, Shibata S, Nagase T, Gotoda T, Ando K, et al. Enhanced aldosterone signaling in the early nephropathy of rats with metabolic syndrome: possible contribution of fat-derived factors. J Am Soc Nephrol. 2006;17(12):3438–46. doi:10.1681/ASN.2006080944.PubMedCrossRef

67.

Engeli S, Bohnke J, Gorzelniak K, Janke J, Schling P, Bader M, et al. Weight loss and the renin-angiotensin-aldosterone system. Hypertension. 2005;45(3):356–62. doi:10.1161/01.HYP.0000154361.47683.d3.PubMedCrossRef

68.

Chagnac A, Weinstein T, Herman M, Hirsh J, Gafter U, Ori Y. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol. 2003;14(6):1480–6.PubMedCrossRef

69.

Straznicky NE, Grima MT, Lambert EA, Eikelis N, Dawood T, Lambert GW, et al. Exercise augments weight loss induced improvement in renal function in obese metabolic syndrome individuals. J Hypertens. 2011;29(3):553–64. doi:10.1097/HJH.0b013e3283418875.PubMedCrossRef

70.

Hirsch J, Leibel RL, Mackintosh R, Aguirre A. Heart rate variability as a measure of autonomic function during weight change in humans. Am J Phys. 1991;261(6 Pt 2):R1418–23.

71.

Rothberg AE, McEwen LN, Kraftson AT, Ajluni N, Fowler CE, Nay CK, et al. Impact of weight loss on waist circumference and the components of the metabolic syndrome. BMJ Open Diabetes Res Care. 2017;5(1):e000341. doi:10.1136/bmjdrc-2016-000341.PubMedPubMedCentralCrossRef

72.

Johnson BL, Blackhurst DW, Latham BB, Cull DL, Bour ES, Oliver TL, et al. Bariatric surgery is associated with a reduction in major macrovascular and microvascular complications in moderately to severely obese patients with type 2 diabetes mellitus. J Am Coll Surg. 2013;216(4):545–556; discussion 56-8. doi:10.1016/j.jamcollsurg.2012.12.019.PubMedCrossRef

73.

Mastellos N, Gunn LH, Felix LM, Car J, Majeed A. Transtheoretical model stages of change for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database Syst Rev. 2014;2:CD008066. doi:10.1002/14651858.CD008066.pub3.

74.

Lin JS, O'Connor EA, Evans CV, Senger CA, Rowland MG, Groom HC. Behavioral counseling to promote a healthy lifestyle for cardiovascular disease prevention in persons with cardiovascular risk factors: an updated systematic evidence review for the U.S. Preventive Services Task Force. US Preventive Services Task Force Evidence Synthesis. 2014.

75.

Wing RR, Bolin P, Brancati FL, Bray GA, Clark JM, Coday M, et al. Look AHEAD research group. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369(2):145–54. doi:10.1056/NEJMoa1212914.PubMedCrossRef

76.

Khera R, Murad MH, Chandar AK, Dulai PS, Wang Z, Prokop LJ, et al. Association of Pharmacological Treatments for obesity with weight loss and adverse events: a systematic review and meta-analysis. JAMA. 2016;315(22):2424–34. doi:10.1001/jama.2016.7602.PubMedCrossRef

77.

Siebenhofer A, Jeitler K, Horvath K, Berghold A, Posch N, Meschik J, et al. Long-term effects of weight-reducing drugs in people with hypertension. Cochrane Database Syst Rev. 2016;3:CD007654. doi:10.1002/14651858.CD007654.pub4.PubMed

78.

•• Chirinos JA, Gurubhagavatula I, Teff K, Rader DJ, Wadden TA, Townsend R, et al. CPAP, weight loss, or both for obstructive sleep apnea. N Engl J Med. 2014;370(24):2265–75. doi:10.1056/NEJMoa1306187. This randomized controlled trail of patients with obesity and moderate to severe sleep apnea evaluated the effects of weight loss, CPAP, or both on several intermediate markers of cardiovascular risk. Combination therapy resulted in greater reduction of insulin resistance, triglyceride levels, and blood pressure than either treatment alone. PubMedPubMedCentralCrossRef

79.

Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149(3):275–87. doi:10.1001/jamasurg.2013.3654.PubMedPubMedCentralCrossRef

80.

•• Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13. doi:10.1056/NEJMoa1401329. This randomized controlled trial of obese type 2 diabetics compared intensive medical therapy to bariatric surgery. Patients who underwent bariatric surgery had much more dramatic weight loss and improved quality of life compared to medical therapy alone. PubMedPubMedCentralCrossRef

81.

Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Nanni G, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015;386(9997):964–73. doi:10.1016/S0140-6736(15)00075-6.PubMedCrossRef

82.

Seravalle G, Colombo M, Perego P, Giardini V, Volpe M, Dell'Oro R, et al. Long-term sympathoinhibitory effects of surgically induced weight loss in severe obese patients. Hypertension. 2014;64(2):431–7. doi:10.1161/HYPERTENSIONAHA.113.02988.PubMedCrossRef

83.

Vest AR, Heneghan HM, Agarwal S, Schauer PR, Young JB. Bariatric surgery and cardiovascular outcomes: a systematic review. Heart. 2012;98(24):1763–77. doi:10.1136/heartjnl-2012-301778.PubMedCrossRef

84.

Li K, Zou J, Ye Z, Di J, Han X, Zhang H, et al. Effects of bariatric surgery on renal function in obese patients: a systematic review and meta analysis. PLoS One. 2016;11(10):e0163907. doi:10.1371/journal.pone.0163907.PubMedPubMedCentralCrossRef

85.

• Chang AR, Chen Y, Still C, Wood GC, Kirchner HL, Lewis M, et al. Bariatric surgery is associated with improvement in kidney outcomes. Kidney Int. 2016;90(1):164–71. doi:10.1016/j.kint.2016.02.039. This propensity score matched cohort study was the first study to evaluate the effect of bariatric surgery on longitudinal renal outcomes. In multivariable adjusted analyses, the study demonstrated a 58% lower risk of 30% decline in renal function and a 57% lower risk of doubling of serum creatinine or end stage renal disease in obese patients who underwent bariatric surgery compared to matched controls. PubMedPubMedCentralCrossRef

86.

Kwok CS, Pradhan A, Khan MA, Anderson SG, Keavney BD, Myint PK, et al. Bariatric surgery and its impact on cardiovascular disease and mortality: a systematic review and meta-analysis. Int J Cardiol. 2014;173(1):20–8. doi:10.1016/j.ijcard.2014.02.026.PubMedCrossRef

87.

Scott JD, Johnson BL, Blackhurst DW, Bour ES. Does bariatric surgery reduce the risk of major cardiovascular events? A retrospective cohort study of morbidly obese surgical patients. Surg Obes Relat Dis. 2013;9(1):32–9. doi:10.1016/j.soard.2011.09.002.PubMedCrossRef

88.

Sjostrom L, Peltonen M, Jacobson P, Sjostrom CD, Karason K, Wedel H, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307(1):56–65. doi:10.1001/jama.2011.1914.PubMedCrossRef

89.

Weingarten TN, Gurrieri C, McCaffrey JM, Ricter SJ, Hilgeman ML, Schroeder DR, et al. Acute kidney injury following bariatric surgery. Obes Surg. 2013;23(1):64–70. doi:10.1007/s11695-012-0766-1.PubMedCrossRef

Titel: Hypertension in Obesity and the Impact of Weight Loss
verfasst von: Jordana B. Cohen
Publikationsdatum: 01.10.2017
Verlag: Springer US
Erschienen in: Current Cardiology Reports / Ausgabe 10/2017
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI: https://doi.org/10.1007/s11886-017-0912-4

Neu im Fachgebiet Kardiologie

19.04.2024 | Vorhofflimmern | Nachrichten

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Hypertension in Obesity and the Impact of Weight Loss

Abstract

Purpose of Review

Recent Findings

Summary

Neu im Fachgebiet Kardiologie

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Sind Betablocker auch für ältere herzschwache Personen nützlich?

Stillende Frauen haben geringeres kardiovaskuläres Risiko

Update Kardiologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 10/2017

Plant-Based Nutrition: An Essential Component of Cardiovascular Disease Prevention and Management

What Does 3D Echocardiography Add to 2D Echocardiography in the Assessment of Mitral Regurgitation?

Role of Cardiac Magnetic Resonance Imaging in Myocardial Infarction

Intracardiac Echocardiography for Structural Heart and Electrophysiological Interventions

Transthyretin Cardiac Amyloidosis

The Initial Evaluation and Management of a Patient with Heart Failure

Neu im Fachgebiet Kardiologie

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Sind Betablocker auch für ältere herzschwache Personen nützlich?

Stillende Frauen haben geringeres kardiovaskuläres Risiko

Update Kardiologie