Obesity Hypertension in the Atherosclerosis Risk in Communities Cohort: Implications of Obesity Guidelines

An estimated 55% of the U.S. adults are overweight or obese (body mass index [BMI] equals 25 kg/m2). Overweight individuals have a threefold increased risk for the development of hypertension compared to lean individuals. The National Institutes of Health, National Heart, Lung, and Blood Institute (NHLBI) guidelines for treatment of overweight and obese adults recommend weight reduction strategies including pharmacologic treatment with antiobesity agents approved by the FDA. Treatment is recommended for obese individuals and for overweight persons with other risk factors for cardiovascular disease (CVD) including hypertension. This analysis of the Atherosclerosis Risk In Communities (ARIC) cohort for overweight/ obese hypertensive participants indicate that 64% of the hypertensive participants in ARIC deserve consideration for treatment with antiobesity agents according to the current NHLBI guidelines. Thus far there are no long term morbidity and mortality clinical trials to determine the safety of antiobesity agents currently approved by the FDA. The authors caution health care providers in the use of these agents in the obese patient with hypertension. (c)1999 by Le Jacq Communications, Inc.