Using beta-blockers as a second-line therapy in combination with certain anti-hypertensive drugs significantly lowers blood pressure in patients with hypertension, according to a systematic review by Cochrane Researchers. This review also goes some way to explaining the differences in the way that patients respond to beta-blockers and other classes of blood pressure lowering drugs.
Beta-blockers are commonly used in the treatment of hypertension (high blood pressure) to help reduce the risk of stroke and cardiovascular disease. They can be used alone or as a second-line therapy in combination with a wide range of anti-hypertensive drugs. The idea behind combining two different drugs to treat hypertension is that each has a different mechanism of action and thus may help tackle different mechanisms involved in causing the condition. In this way, greater decreases in blood pressure may be achieved than with single drug therapy.
The review included 20 trials involving a total of 3,744 patients. Overall, the researchers found that adding beta-blockers as the second-line drug, in combination with thiazide diuretics or calcium channel blockers, caused an additional blood pressure reduction. The reduction was around 30% greater when the dose was doubled.
This data was compared with a Cochrane Review published in Issue 4, 2009 that examined the blood pressure lowering effect of second-line thiazide diuretics. They concluded that the two drugs produced different patterns of blood pressure lowering. Second-line beta-blockers were found to be more effective at reducing diastolic blood pressure (the minimum pressure in the arteries between beats when the heart relaxes to fill with blood) but had little or no effect on pulse pressure, while second-line thiazides significantly decreased pulse pressure in a dose-related manner.
"We feel that these findings are generalisable to most patients being treated for hypertension where a beta-blocker is added as a second-line drug to a first-line thiazide," said lead researcher, Jenny Chen, who works in Pharmacology and Therapeutics at the University of British Columbia in Vancouver, Canada. "The finding that beta-blockers produce a different pattern of blood pressure lowering to thiazides when used as second-line drugs certainly deserves further attention as it might explain why beta-blockers appear to be less effective than thiazide diuretics at reducing adverse cardiovascular outcomes, particularly in older individuals."
"The major limitation of this work is that we only know what happens when you add beta-blockers to thiazides and calcium channel blockers. It is possible that adding beta-blockers to other classes of drugs might produce a different result," said Chen.
Source: Jennifer Beal
Wiley-Blackwell
Friday 22 January 2010
Wednesday 20 January 2010
Tuesday 19 January 2010
How low can Mike go? - Vital health statistics.
Below you will find my vital statistics so that you can track how well each remedy works in lowering my blood pressure:
Start of the challenge - the size of the task aheadMike's health statistics:
Blood Pressure - 128/80 mmHg
(Ideal blood pressure is 120/80 mmHg or lower on both numbers. So Mike is 8mm Hg above ideal blood pressure for the top number or systolic blood pressure)
Pulse - 74 beats per minute
Weight - 98.5 kg or 15 st 7 lbs
(Ideal weight for height is between 11 and 14 stone. The current weight is Overweight)
Height - 1.87 metres or 6 feet 2 inches
BMI - 28.17 kg/metres2
(Ideal BMI is between 18.5 and 25. The current BMI is in the Overweight category)
Waist circumference - 100 cm or 39 inches
(Ideal waist measurement is less than 37 inches for White and African Caribbean men. Being above this increases the risk of health problems such as diabetes)
Non-smoker
(Not smoking reduces the risk of heart disease and stroke)
Alcohol consumption - 0 units per week
(Drinking less than 21 units per week for men and 14 units per week for women is recommended)
Exercise - Moderately inactive
(Active would be ideal)
Total Cholesterol - 4.77 mmols/L
(Ideal is 5.0 or less)
HDL Cholesterol - 1.23 mmols/L
(Ideal is more than 1.0)
LDL Cholesterol - 2.75 mmols/L
(Ideal is less than 3.0)
Total Cholesterol/HDL Cholesterol Ratio - 3.9
(Ideal is less than 4.0)
Triglycerides - 1.65
Non-fasting (random) Glucose level - 5.03
Family History of Diabetes - Yes. 1st degree relative had diabetes
(Having a close relative with diabetes increases the risk of developing diabetes)
Family History of Cardiovascular Disease - No.
(Having relatives with cardiovascular disease increases the risk of developing heart problems)
Ethnicity - White
Medication:
Atenolol 50 mg a day
(A blood pressure lowering tablet, from the beta-blocker family of medications)
Amlodipine 5 mg a day
(A blood pressure lowering tablet, from the calcium channel blocker family of medications)
Simvastatin 10 mg a day
(A cholesterol lowering tablet)
Start of the challenge - the size of the task aheadMike's health statistics:
Blood Pressure - 128/80 mmHg
(Ideal blood pressure is 120/80 mmHg or lower on both numbers. So Mike is 8mm Hg above ideal blood pressure for the top number or systolic blood pressure)
Pulse - 74 beats per minute
Weight - 98.5 kg or 15 st 7 lbs
(Ideal weight for height is between 11 and 14 stone. The current weight is Overweight)
Height - 1.87 metres or 6 feet 2 inches
BMI - 28.17 kg/metres2
(Ideal BMI is between 18.5 and 25. The current BMI is in the Overweight category)
Waist circumference - 100 cm or 39 inches
(Ideal waist measurement is less than 37 inches for White and African Caribbean men. Being above this increases the risk of health problems such as diabetes)
Non-smoker
(Not smoking reduces the risk of heart disease and stroke)
Alcohol consumption - 0 units per week
(Drinking less than 21 units per week for men and 14 units per week for women is recommended)
Exercise - Moderately inactive
(Active would be ideal)
Total Cholesterol - 4.77 mmols/L
(Ideal is 5.0 or less)
HDL Cholesterol - 1.23 mmols/L
(Ideal is more than 1.0)
LDL Cholesterol - 2.75 mmols/L
(Ideal is less than 3.0)
Total Cholesterol/HDL Cholesterol Ratio - 3.9
(Ideal is less than 4.0)
Triglycerides - 1.65
Non-fasting (random) Glucose level - 5.03
Family History of Diabetes - Yes. 1st degree relative had diabetes
(Having a close relative with diabetes increases the risk of developing diabetes)
Family History of Cardiovascular Disease - No.
(Having relatives with cardiovascular disease increases the risk of developing heart problems)
Ethnicity - White
Medication:
Atenolol 50 mg a day
(A blood pressure lowering tablet, from the beta-blocker family of medications)
Amlodipine 5 mg a day
(A blood pressure lowering tablet, from the calcium channel blocker family of medications)
Simvastatin 10 mg a day
(A cholesterol lowering tablet)
How low can Mike go? - The aim of the challenge.
Mike's blood pressure lowering diary blog
Each week I will write a diary blog entry to let you know how he fared with each approach he tries to help lower his blood pressure.
Come back each to week to follow my progress:
Start of the Challenge - Taking stock of my health
Here we go! The start of “How low can Mike go?”.
Am I nervous? Well, yes!
I have to say that I am a bit nervous. I have never been one to stick to a routine and putting myself online with this programme feels like I have pushed myself into a corner. Let’s hope it works.
It's a daunting challenge
Over the next few months, I am going to be experimenting with a number of remedies that are reputed to be good for your blood pressure. I will be trying everything from beetroot juice to yoga to see if they work. More importantly, I will be following some of the standard advice that all of us with high blood pressure are given – I am going to be doing more exercise and I am going to improve my diet.
Taking stock of my health with a basic health check
Before Christmas I underwent a basic health check which went over my blood pressure, cholesterol levels diet, activity and weight. The good news was that my blood pressure was well controlled and my cholesterol level was around 5. I am fairly convinced that this is due to the fact that I do take my medication on a regular basis. I am on atenolol and amlodopine for my blood pressure and simvastatin for my cholesterol.
My lifestyle is the problem
My big problem is weight. I weigh just over 15 and a half stone and although I am around six foot two inches tall this still gives me a BMI of almost 28 – well into the overweight level and not far away from obese.
I would admit that my diet is poor. I eat badly and not in any regular way. I need to cut down on my salt intake and fats. I also do next to no exercise. I drive to work, do a bit of walking but could really improve this area of my life.
My hopes for the challenge
My goals. I want to get fitter, get thinner and improve my health. Both my parents died in their 60s and didn’t get the chance to meet most of their grandchildren. I want to be around for a long time yet – so that’s my major objective.
Come back regularly to see how I get on
I am going to update this blog on a regular basis. I have enrolled on the Imperative programme and will be undergoing some tests such as having my metabolic rate measured. Next week I will be counting my calories. Join me later to find out how much I really eat!
Each week I will write a diary blog entry to let you know how he fared with each approach he tries to help lower his blood pressure.
Come back each to week to follow my progress:
Start of the Challenge - Taking stock of my health
Here we go! The start of “How low can Mike go?”.
Am I nervous? Well, yes!
I have to say that I am a bit nervous. I have never been one to stick to a routine and putting myself online with this programme feels like I have pushed myself into a corner. Let’s hope it works.
It's a daunting challenge
Over the next few months, I am going to be experimenting with a number of remedies that are reputed to be good for your blood pressure. I will be trying everything from beetroot juice to yoga to see if they work. More importantly, I will be following some of the standard advice that all of us with high blood pressure are given – I am going to be doing more exercise and I am going to improve my diet.
Taking stock of my health with a basic health check
Before Christmas I underwent a basic health check which went over my blood pressure, cholesterol levels diet, activity and weight. The good news was that my blood pressure was well controlled and my cholesterol level was around 5. I am fairly convinced that this is due to the fact that I do take my medication on a regular basis. I am on atenolol and amlodopine for my blood pressure and simvastatin for my cholesterol.
My lifestyle is the problem
My big problem is weight. I weigh just over 15 and a half stone and although I am around six foot two inches tall this still gives me a BMI of almost 28 – well into the overweight level and not far away from obese.
I would admit that my diet is poor. I eat badly and not in any regular way. I need to cut down on my salt intake and fats. I also do next to no exercise. I drive to work, do a bit of walking but could really improve this area of my life.
My hopes for the challenge
My goals. I want to get fitter, get thinner and improve my health. Both my parents died in their 60s and didn’t get the chance to meet most of their grandchildren. I want to be around for a long time yet – so that’s my major objective.
Come back regularly to see how I get on
I am going to update this blog on a regular basis. I have enrolled on the Imperative programme and will be undergoing some tests such as having my metabolic rate measured. Next week I will be counting my calories. Join me later to find out how much I really eat!
Friday 15 January 2010
How low can Mike go?
It has started. My journey to find out how I can lower my blood pressure through a mix of traditional approaches such as exercise an diet as well as a range of more esoteric approaches like beetroot juice and yoga. Vote on what you want him to try and follow his progress.
http://www.bpassoc.org.uk/microsites/Howlowcanmikego/Home
http://www.bpassoc.org.uk/microsites/Howlowcanmikego/Home
Thursday 14 January 2010
New York declares war on salt - should it be London next?
The city's Health Department announced on Monday that it is coordinating a nationwide effort to reduce salt in restaurant and packaged foods by 25 percent over five years.
The National Salt Reduction Initiative, a coalition of cities and health organizations, hopes the food industry will back its campaign to combat high blood pressure, heart attacks and strokes by voluntarily reducing the sodium in the U.S. food supply.
The announcement met with mixed reaction. Many food makers have already begun to cut salt content and said the reduction targets were reasonable, but some critics called it another attempt to regulate what should be a free choice.
Bloomberg, who has just begun his third term as mayor, has crusaded for healthy living. Apart from the smoking and trans fat bans, the city required chain restaurants to post calorie counts of their menu items and started ad advertising campaign against sugary drinks.
Companies are aware of the push to reduce salt and the New York initiative represents a challenge, said Tom Forte, an analyst at Telsey Advisory Group, an equity research firm.
The restaurant industry will change its offerings if demand is there, but there is "not a lot of proof" previous measures in New York caused any major shifts in consumer behavior, Forte said.
The effort targets restaurants and packaged food because only 11 percent of the sodium in Americans' diets comes from their saltshakers. Nearly 80 percent is added to foods before they are sold, the Health Department said.
High blood pressure, heart attacks and stroke kill 23,000 New Yorkers and 800,000 Americans per year, costing untold billions in healthcare expenses, the Health Department said. Salt intake has been increasing steadily since the 1970s, with Americans consuming about twice the recommended limit of salt each day.
"Consumers can always add salt to food, but they can't take it out," said New York City Health Commissioner Thomas Farley.
But J. Justin Wilson of the Center for Consumer Freedom, an industry-funded group that lobbies against restrictions on smoking, alcohol and the restaurant and food industries, called the initiative "paternalistic" and warned that if the City doesn't get its way, it may try to make the proposals obligatory.
"First it was trans fats, then it was mandatory labeling. The City's Board of Health knows best."
Food manufacturers said the proposals are reasonable and have been a part of their strategy for some time.
"Kraft Foods is supportive of the overall goal of New York City's sodium reduction initiative," said Susan Davidson of Kraft Foods Inc.
The New York City Health Department's Dr. Sonia Angell said the sodium cuts are "not about banning any single product" but making sure the mix of high and low sodium products is balanced so that it packs "a lower wallop of sodium for all of us."
Source: Reuters
The National Salt Reduction Initiative, a coalition of cities and health organizations, hopes the food industry will back its campaign to combat high blood pressure, heart attacks and strokes by voluntarily reducing the sodium in the U.S. food supply.
The announcement met with mixed reaction. Many food makers have already begun to cut salt content and said the reduction targets were reasonable, but some critics called it another attempt to regulate what should be a free choice.
Bloomberg, who has just begun his third term as mayor, has crusaded for healthy living. Apart from the smoking and trans fat bans, the city required chain restaurants to post calorie counts of their menu items and started ad advertising campaign against sugary drinks.
Companies are aware of the push to reduce salt and the New York initiative represents a challenge, said Tom Forte, an analyst at Telsey Advisory Group, an equity research firm.
The restaurant industry will change its offerings if demand is there, but there is "not a lot of proof" previous measures in New York caused any major shifts in consumer behavior, Forte said.
The effort targets restaurants and packaged food because only 11 percent of the sodium in Americans' diets comes from their saltshakers. Nearly 80 percent is added to foods before they are sold, the Health Department said.
High blood pressure, heart attacks and stroke kill 23,000 New Yorkers and 800,000 Americans per year, costing untold billions in healthcare expenses, the Health Department said. Salt intake has been increasing steadily since the 1970s, with Americans consuming about twice the recommended limit of salt each day.
"Consumers can always add salt to food, but they can't take it out," said New York City Health Commissioner Thomas Farley.
But J. Justin Wilson of the Center for Consumer Freedom, an industry-funded group that lobbies against restrictions on smoking, alcohol and the restaurant and food industries, called the initiative "paternalistic" and warned that if the City doesn't get its way, it may try to make the proposals obligatory.
"First it was trans fats, then it was mandatory labeling. The City's Board of Health knows best."
Food manufacturers said the proposals are reasonable and have been a part of their strategy for some time.
"Kraft Foods is supportive of the overall goal of New York City's sodium reduction initiative," said Susan Davidson of Kraft Foods Inc.
The New York City Health Department's Dr. Sonia Angell said the sodium cuts are "not about banning any single product" but making sure the mix of high and low sodium products is balanced so that it packs "a lower wallop of sodium for all of us."
Source: Reuters
Having children is good for your blood pressure?
Being a parent can be stressful, but new research calls into question some long-held beliefs about physical and psychological effects of having kids.
A study published today in Annals of Behavioral Medicine finds that parents have better blood pressure readings than childless adults.
"Women were driving the effect," says co-author Julianne Holt-Lunstad, a psychologist at Brigham Young University in Provo, Utah. "Women with children had the lowest blood pressure, and women without had the highest" of those studied.
Holt-Lunstad, along with researchers from the University of Utah in Salt Lake City and California State University-Long Beach, monitored the blood pressure of 198 adults ages 20-68. Participants wore portable monitors, which took random readings three times an hour, multiple times a day, over 24 hours, including while they slept.
The researchers considered other factors that influence blood pressure, such as age, body mass, gender, exercise, employment and smoking. They controlled for length of marriage and duration of marriage before kids. Researchers compared parents with kids under age 2 to parents with teens to parents with kids over 18 and found no differences.
Thomas Kamarck, a professor of psychology and psychiatry at the University of Pittsburgh who has researched nighttime blood pressure, says he's not sure about the link to parenthood.
He hasn't yet seen the new study, but he says that "the fact that there's no difference between young children and adult children" suggests that blood pressure readings reflect "something about the people who choose to be parents, rather than the day-to-day experience of being a parent" that may account for the findings.
Holt-Lunstad says researchers need to study parents and other adults over time to see whether parenthood actually does reduce blood pressure.
Source: USA Today
A study published today in Annals of Behavioral Medicine finds that parents have better blood pressure readings than childless adults.
"Women were driving the effect," says co-author Julianne Holt-Lunstad, a psychologist at Brigham Young University in Provo, Utah. "Women with children had the lowest blood pressure, and women without had the highest" of those studied.
Holt-Lunstad, along with researchers from the University of Utah in Salt Lake City and California State University-Long Beach, monitored the blood pressure of 198 adults ages 20-68. Participants wore portable monitors, which took random readings three times an hour, multiple times a day, over 24 hours, including while they slept.
The researchers considered other factors that influence blood pressure, such as age, body mass, gender, exercise, employment and smoking. They controlled for length of marriage and duration of marriage before kids. Researchers compared parents with kids under age 2 to parents with teens to parents with kids over 18 and found no differences.
Thomas Kamarck, a professor of psychology and psychiatry at the University of Pittsburgh who has researched nighttime blood pressure, says he's not sure about the link to parenthood.
He hasn't yet seen the new study, but he says that "the fact that there's no difference between young children and adult children" suggests that blood pressure readings reflect "something about the people who choose to be parents, rather than the day-to-day experience of being a parent" that may account for the findings.
Holt-Lunstad says researchers need to study parents and other adults over time to see whether parenthood actually does reduce blood pressure.
Source: USA Today
Dementia in older women linked to hypertension earlier in life
Hypertension may put women at greater risk for dementia later in life by increasing white matter abnormalities in the brain, a new study suggested.
The analysis included 1,403 women aged 65 years or older included in the multicenter, long-term Women’s Health Initiative Memory Study; 883 had been randomized in the conjugated equine estrogen plus medroxyprogesterone acetate study (436 active; 447 placebo) and 520 had been randomized in the conjugated equine estrogens alone study (257 active; 263 placebo).
All participants had their BP assessed annually and underwent brain MRI. Researchers assessed white matter lesions, which are associated with increased risks for dementia and stroke.
Women who were hypertensive at baseline (31%; ≥140 mm Hg/90 mm Hg) had significantly more white matter lesions on their MRI scans eight years later compared with women who had normal BP. Lesions were most common at the frontal lobe than in the occipital, parietal or temporal lobes.
Women taking antihypertensive therapy had greater white matter lesion volumes compared with women not taking antihypertensive therapy (P=.03).
When the researchers repeated the analysis based on late on-trial BP data and antihypertensive medication status, white matter lesion volumes remained significantly related to baseline BP levels for women not taking antihypertensive drugs, but not for women taking antihypertensive drugs.
“Proper control of BP, which remains generally poor, may be very important to prevent dementia as women age,” researcher Lewis Kuller, MD, DrPH, professor of epidemiology, University of Pittsburgh Graduate School of Public Health, said in a press release. “Women should be encouraged to control high BP when they are young or in middle-age in order to prevent serious problems later on.”
The research was funded by grants from the National Institutes of Health’s National Heart, Lung, and Blood Institute and the U.S. Department of Health and Human Services.
Kuller LH. J Clin Hypertens. 2009;doi:10.1111/j.1751-7176.2009.00234.x.
The analysis included 1,403 women aged 65 years or older included in the multicenter, long-term Women’s Health Initiative Memory Study; 883 had been randomized in the conjugated equine estrogen plus medroxyprogesterone acetate study (436 active; 447 placebo) and 520 had been randomized in the conjugated equine estrogens alone study (257 active; 263 placebo).
All participants had their BP assessed annually and underwent brain MRI. Researchers assessed white matter lesions, which are associated with increased risks for dementia and stroke.
Women who were hypertensive at baseline (31%; ≥140 mm Hg/90 mm Hg) had significantly more white matter lesions on their MRI scans eight years later compared with women who had normal BP. Lesions were most common at the frontal lobe than in the occipital, parietal or temporal lobes.
Women taking antihypertensive therapy had greater white matter lesion volumes compared with women not taking antihypertensive therapy (P=.03).
When the researchers repeated the analysis based on late on-trial BP data and antihypertensive medication status, white matter lesion volumes remained significantly related to baseline BP levels for women not taking antihypertensive drugs, but not for women taking antihypertensive drugs.
“Proper control of BP, which remains generally poor, may be very important to prevent dementia as women age,” researcher Lewis Kuller, MD, DrPH, professor of epidemiology, University of Pittsburgh Graduate School of Public Health, said in a press release. “Women should be encouraged to control high BP when they are young or in middle-age in order to prevent serious problems later on.”
The research was funded by grants from the National Institutes of Health’s National Heart, Lung, and Blood Institute and the U.S. Department of Health and Human Services.
Kuller LH. J Clin Hypertens. 2009;doi:10.1111/j.1751-7176.2009.00234.x.
Thursday 7 January 2010
Loss of sleep due to monitoring affects blood pressure patterns
The 24-hour ambulatory blood pressure monitoring may interfere with patients' sleep, thus affecting the results of the test, according to a study in Clinical Journal of the American Society of Nephrology.
"Blood pressure (BP), measured during sleep, correlates better with heart attacks and strokes compared to blood pressure measured in the doctor's office," said Rajiv Agarwal, MD, Indiana University and Veterans Affairs Medical Center, Indianapolis. "However, if blood pressure measurement disturbs sleep, then it may weaken the relationship between 'sleeping BP' and these cardiovascular events."
Agarwal and his data-manager, Robert Light, BS, analyzed the results of 24-hour blood pressure monitoring in 103 patients with kidney disease. This monitoring test is commonly performed to assess variations in blood pressure from daytime to nighttime. Each study participant also wore an actigraph to monitor activity levels.
A lack of the normal nighttime “dip” in blood pressure was related to increased activity levels, because the monitor was disturbing the patients' sleep. On nights when patients were using the blood pressure monitor, they spent an average of 90 minutes less in bed. The study participants also spent less time asleep and slept less efficiently.
"We were measuring activity, sleep, and ambulatory BP for diagnosing masked hypertension and found this interesting observation," said Agarwal.
Patients who awoke at night during blood pressure monitoring were 10 times less likely to have the normal nighttime dip in BP.
"Nighttime blood pressure is lower not because of the time of the day, but because people are asleep," said Agarwal. "The ambulatory monitoring technique can disturb sleep, and therefore raise the nighttime blood pressure as an artifact.”
Agarwal emphasized that sleep quality should be taken into account when interpreting blood pressure during sleep.
"Blood pressure (BP), measured during sleep, correlates better with heart attacks and strokes compared to blood pressure measured in the doctor's office," said Rajiv Agarwal, MD, Indiana University and Veterans Affairs Medical Center, Indianapolis. "However, if blood pressure measurement disturbs sleep, then it may weaken the relationship between 'sleeping BP' and these cardiovascular events."
Agarwal and his data-manager, Robert Light, BS, analyzed the results of 24-hour blood pressure monitoring in 103 patients with kidney disease. This monitoring test is commonly performed to assess variations in blood pressure from daytime to nighttime. Each study participant also wore an actigraph to monitor activity levels.
A lack of the normal nighttime “dip” in blood pressure was related to increased activity levels, because the monitor was disturbing the patients' sleep. On nights when patients were using the blood pressure monitor, they spent an average of 90 minutes less in bed. The study participants also spent less time asleep and slept less efficiently.
"We were measuring activity, sleep, and ambulatory BP for diagnosing masked hypertension and found this interesting observation," said Agarwal.
Patients who awoke at night during blood pressure monitoring were 10 times less likely to have the normal nighttime dip in BP.
"Nighttime blood pressure is lower not because of the time of the day, but because people are asleep," said Agarwal. "The ambulatory monitoring technique can disturb sleep, and therefore raise the nighttime blood pressure as an artifact.”
Agarwal emphasized that sleep quality should be taken into account when interpreting blood pressure during sleep.
Wednesday 6 January 2010
Overweight and middle aged men at risk of earlier death
Overweight middle-aged men may have a higher risk of heart problems and strokes and die earlier than their thinner peers -- even in the absence of some traditional risk factors, a new study suggests.
Some past research has suggested that when obese and overweight adults do not have the so-called metabolic syndrome, their risks of diabetes, heart disease and stroke are no higher than those of normal-weight people.
Metabolic syndrome refers to a collection of risk factors for diabetes and heart problems -- including abdominal obesity, high blood pressure, elevated blood sugar, low levels of "good" HDL cholesterol and high triglycerides (another type of blood fat). It is typically diagnosed when a person has three or more of those conditions.
In the current study, which followed more than 1,700 Swedish men for 30 years, overweight and obese men had increased risks of conditions including heart attack and stroke, even when in the absence of metabolic syndrome.
Among all men without metabolic syndrome, those who were overweight were 52 percent more likely to have heart attacks, strokes, and other complications than normal-weight men were, while obese men had nearly double the risk.
The findings are published in the American Heart Association journal Circulation.
"Our study shows that overweight (and) obese men without the metabolic syndrome are at higher risk" for heart disease, stroke, and other related conditions, study leader Dr. Johan Arnlov, of Uppsala University in Sweden, told Reuters Health by email. "This is in contrast to some previous studies that have suggested that obesity in the absence of the metabolic syndrome is a 'healthy' condition."
The study does, however, point up the added threat of having metabolic syndrome.
Obese men with metabolic syndrome had the highest risks -- showing 2.5 times the risk of heart disease and stroke, and related conditions, and of death, during the study period as men who were normal-weight and free of metabolic syndrome at the outset.
In addition, metabolic syndrome was harmful for normal-weight men as well; those with the condition were 63 percent more likely to develop heart disease, stroke, and related conditions than their counterparts who were free of metabolic syndrome.
According to Arnlov, the findings suggest that weight loss should be a goal for heavy men, regardless of whether they have metabolic syndrome. At the same time, being thin does not mean equate to a healthy heart -- though, Arnlov pointed out, metabolic syndrome is much more common among overweight people.
The findings are based on 1,758 men who, at the outset, were 50 years old and free of diabetes and previous hospitalizations for heart disease, stroke, and related conditions. Of the 955 normal-weight men, 64 had metabolic syndrome, as did 125 of 707 overweight men, and 66 of 96 obese men.
Over the next 30 years, 681 men suffered a heart attack, stroke or other major related complication. A total of 845 died.
Heavy men without metabolic syndrome had increased risks of such complications and death even with age, smoking and levels of "bad" LDL cholesterol taken into account.
It is not entirely clear why overweight men were at increased risk, but one issue the study did not address was physical fitness, AHA spokesman Dr. Barry Franklin noted in the news release from the heart association.
He suggested that as a "New Year's resolution," overweight adults recognize that there are health benefits to be gained from shedding even a few pounds through diet changes and exercise.
Arnlov said that future studies should look at whether similar findings are seen in women. However, he added, "I don't think we should consider obesity without the metabolic syndrome to be benign in women just because we don't have the data yet."
SOURCE: Reuters Health / Circulation, online December 28, 2009.
Some past research has suggested that when obese and overweight adults do not have the so-called metabolic syndrome, their risks of diabetes, heart disease and stroke are no higher than those of normal-weight people.
Metabolic syndrome refers to a collection of risk factors for diabetes and heart problems -- including abdominal obesity, high blood pressure, elevated blood sugar, low levels of "good" HDL cholesterol and high triglycerides (another type of blood fat). It is typically diagnosed when a person has three or more of those conditions.
In the current study, which followed more than 1,700 Swedish men for 30 years, overweight and obese men had increased risks of conditions including heart attack and stroke, even when in the absence of metabolic syndrome.
Among all men without metabolic syndrome, those who were overweight were 52 percent more likely to have heart attacks, strokes, and other complications than normal-weight men were, while obese men had nearly double the risk.
The findings are published in the American Heart Association journal Circulation.
"Our study shows that overweight (and) obese men without the metabolic syndrome are at higher risk" for heart disease, stroke, and other related conditions, study leader Dr. Johan Arnlov, of Uppsala University in Sweden, told Reuters Health by email. "This is in contrast to some previous studies that have suggested that obesity in the absence of the metabolic syndrome is a 'healthy' condition."
The study does, however, point up the added threat of having metabolic syndrome.
Obese men with metabolic syndrome had the highest risks -- showing 2.5 times the risk of heart disease and stroke, and related conditions, and of death, during the study period as men who were normal-weight and free of metabolic syndrome at the outset.
In addition, metabolic syndrome was harmful for normal-weight men as well; those with the condition were 63 percent more likely to develop heart disease, stroke, and related conditions than their counterparts who were free of metabolic syndrome.
According to Arnlov, the findings suggest that weight loss should be a goal for heavy men, regardless of whether they have metabolic syndrome. At the same time, being thin does not mean equate to a healthy heart -- though, Arnlov pointed out, metabolic syndrome is much more common among overweight people.
The findings are based on 1,758 men who, at the outset, were 50 years old and free of diabetes and previous hospitalizations for heart disease, stroke, and related conditions. Of the 955 normal-weight men, 64 had metabolic syndrome, as did 125 of 707 overweight men, and 66 of 96 obese men.
Over the next 30 years, 681 men suffered a heart attack, stroke or other major related complication. A total of 845 died.
Heavy men without metabolic syndrome had increased risks of such complications and death even with age, smoking and levels of "bad" LDL cholesterol taken into account.
It is not entirely clear why overweight men were at increased risk, but one issue the study did not address was physical fitness, AHA spokesman Dr. Barry Franklin noted in the news release from the heart association.
He suggested that as a "New Year's resolution," overweight adults recognize that there are health benefits to be gained from shedding even a few pounds through diet changes and exercise.
Arnlov said that future studies should look at whether similar findings are seen in women. However, he added, "I don't think we should consider obesity without the metabolic syndrome to be benign in women just because we don't have the data yet."
SOURCE: Reuters Health / Circulation, online December 28, 2009.
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