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Unfavourable blood pressure and LDL-cholesterol levels in obese non-diabetic individuals
B H R Wolffenbuttel1, S N Slagter, R P van Waateringe
1Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Insights
Obese individuals, particularly younger men, have higher blood pressure (BP) and LDL-cholesterol (LDL-C). Treatments improved but did not normalize BP, while statins reduced age-related LDL-C increases.
Area of Science:
- Cardiovascular health
- Obesity research
- Public health
Background:
- Early detection and management of hypertension and high cholesterol are crucial for cardiovascular risk reduction.
- This study investigates differences in blood pressure (BP) and LDL-cholesterol (LDL-C) between obese and normal-weight individuals.
Purpose of the Study:
- To compare BP and LDL-C levels in obese versus normal weight and overweight individuals.
- To evaluate the quality of treatment for hypertension and high cholesterol across different BMI categories.
Main Methods:
- Analysis of 87,648 participants from the Lifelines study, categorized by obesity status and age.
- Calculation of mean systolic BP and LDL-C based on treatment, BMI, age, and sex.
Main Results:
- Obese individuals exhibited significantly higher BP across all ages compared to normal weight and overweight individuals, most notably in men under 50.
- Despite medication, BP control was insufficient in 20-50% of participants.
- Obese participants had higher LDL-C than normal-weight individuals, even with increased statin use; statins effectively mitigated age-related LDL-C increases.
Conclusions:
- Obesity is linked to elevated BP and LDL-C, particularly in younger men.
- BP-lowering drugs did not fully normalize BP to age and BMI-specific levels.
- Increased attention to active screening and treatment of cardiovascular risk factors in obese populations is warranted.
Background:
Early diagnosis and treatment of high blood pressure (BP) and cholesterol is important to reduce cardiovascular risk. We compared BP and LDL-cholesterol (LDL-C) as well as the quality of treatment between obese subjects and normal weight and overweight individuals.
Methods:
87,648 participants of the Lifelines study were categorised according to obesity (normal weight/ overweight/obesity) and age. Mean systolic BP and LDL-C were calculated depending on treatment, BMI, age and sex.
Results:
In all age groups, except those aged 70-80 years, women had a significantly lower BP than men. Use of BP-lowering medication did not result in BP levels comparable with non-users, except in those aged 70-80 years. Despite medication, the BP was insufficiently controlled in 20-50% of participants. BP was significantly higher in obese vs. normal weight and overweight individuals of all ages, but most apparently in men younger than 50 years. Mean LDL-C varied between 2.5- .0 mmol/l. Despite higher statin use, obese participants had a higher LDL-C than those with a normal weight. Statins abolished the age-dependent LDL-C increase. Many participants did not achieve target LDL-C < 2.5 mmol/l. A small percentage of individuals treated with BP-lowering drugs were also using statins (overall 32% in men, 17% in women).
Conclusion:
Obese individuals, especially men younger than 50, have a higher BP and LDL-C compared with those with overweight and a normal weight. Use of BP-lowering drugs did not revert the BP back to levels normal for the specific age and BMI group, whereas statins abolished the age-related increase in LDL-C. These data suggest that more attention is needed for active screening and treatment of cardiovascular risk factors.
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