Tuesday 3 September 2013: Low BMI is a risk factor for CVD in hypertensive patients with diabetes, according to research presented at the ESC Congress today by Dr Takanori Nagahiro from Japan. The findings provide evidence for an obesity paradox in hypertensive patients with glucose intolerance.
Dr Nagahiro said: "Obesity is a risk factor for cardiovascular disease (CVD) but several studies have reported that low body mass index (BMI, kg/m2) was associated with worse cardiovascular outcome compared to middle or higher BMI. This strange phenomenon is called the 'obesity paradox' and has been described in patients with stroke, heart failure, coronary artery disease and renal disease."
He added: "The obesity paradox was reported in diabetic patients in 2012. Adults who were normal weight at the time of incident diabetes had higher mortality than adults who were overweight or obese.1 However, the relationship between obesity and cardiovascular events in patients with diabetes and hypertension is unknown."
The current study assessed the relationship between BMI and cardiovascular events in patients with hypertension and glucose intolerance. The researchers used data from the Nagoya Heart Study, a randomised trial comparing the efficacies of valsartan and amlodipine among 1,105 hypertensive patients with glucose intolerance in Japan. Patients were enrolled from October 2004 to January 2009 and the median follow-up was 3.2 years. The CVD endpoint was a composite of acute myocardial infarction, stroke, admission due to heart failure, coronary revascularization, or sudden cardiac death.Patients were classified2 into four groups according to their baseline BMI:
Dr Nagahiro said: "As BMI increased, CVD risk decreased among Japanese hypertensive patients with glucose intolerance. After adjustment for age, gender and smoking status, the lowest BMI group showed the highest CVD incidence and the highest BMI group had the lowest CVD incidence. CVD risk in the highest BMI group was less than one-third that of the lowest BMI group."
The Kaplan-Meier curve shows the proportion of patients who reached the primary endpoint over time (see figure). The maximum follow-up period was 2,126 days (5.8 years). Dr Nagahiro said: "Our study shows that there is an obesity paradox in hypertensive patients with glucose intolerance. This may be because of the severity of diabetes mellitus in the lowest BMI group. Baseline HbA1c and disease duration is similar to other groups however the percentage of insulin therapy is higher than other groups. This background indicates that the severity of diabetes mellitus is different. The two middle BMI groups had similar CVD risk, probably because mild obesity needs more time to exert an adverse effect on the cardiovascular system."
He concluded: "Hypertensive patients with glucose intolerance and a high BMI should lose weight and restore their BMI to normal range. The results of our study did not refute the fact that severe obesity is a CVD risk factor."
Jacqueline Partarrieu | EurekAlert!
Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel
Oxygen loss in the coastal Baltic Sea is “unprecedentedly severe”
05.07.2018 | European Geosciences Union
For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.
To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...
For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.
Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...
Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.
A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...
Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.
"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....
Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.
Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...
13.07.2018 | Event News
12.07.2018 | Event News
03.07.2018 | Event News
18.07.2018 | Life Sciences
18.07.2018 | Materials Sciences
18.07.2018 | Health and Medicine