The Prevalence of Obesity-Related Hypertension and Risk for New Vascular Events in Patients With Vascular Diseases
Obesity, Exclusive Author Commentary

Vernooij JWP et al. – The prevalence of the combination of hypertension and obesity is low in patients with vascular diseases and does not confer a higher risk for recurrent vascular diseases and mortality than each risk factor alone.

Hypertension and obesity are closely related, but it is not known well whether this is also present in patients with clinical manifest vascular diseases and whether the co-existence of the two confers a higher vascular risk. In the present study we found a low prevalence of the combined presence of hypertension and obesity in patients with clinical manifest vascular diseases. Blood pressure increased only marginally with increasing body mass index. The combination of obesity and hypertension did not add to the risk for all vascular events and all-cause mortality compared to none or one of these risk factors. Our study population consisted of patients with a (recent) clinical manifestation of a vascular disease. The low prevalence of hypertension in combination with obesity is mainly caused by the low prevalence of obesity. In the patients with obesity the prevalence of hypertension is high. The absence of a clear relation between body mass index and the prevalence of hypertension was unexpected. If obesity is a cause of hypertension, the relation between obesity and hypertension may change over time. Long standing hypertension may lead to arterial stiffening and glomerulosclerosis, both causes of hypertension itself. Many patients with vascular diseases are likely to already have hypertension, irrespective of the underlying cause, for a long period leading to arterial stiffening and impaired renal function which caused hypertension independent of obesity.

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