Burden and rates of treatment and control of cardiovascular disease risk factors in obesity: the Framingham Heart Study.
OBJECTIVE
Obesity is associated with an increased risk for cardiovascular disease (CVD). We sought to determine rates of treatment and control of CVD risk factors among normal weight, overweight, and obese individuals in a community-based cohort.


METHODS
Participants free of CVD (n = 6,801; mean age 49 years; 54% women) from the Framingham Offspring and Third Generation cohorts who attended the seventh Offspring examination (1998-2001) or first Third Generation (2002-2005) examination were studied.


RESULTS
Obese participants with hypertension were more likely to receive antihypertensive treatment (62.3%) than normal weight (58.7%) or overweight (59.0%) individuals (P = 0.002), but no differences in hypertension control across BMI subgroups among participants with hypertension were observed (36.7% [normal weight], 37.3% [overweight], and 39.4% [obese]; P = 0.48). Rates of lipid-lowering treatment were higher among obese participants with elevated LDL cholesterol (39.5%) compared with normal weight (34.2%) or overweight (36.4%) participants (P = 0.02), but control rates among those with elevated LDL cholesterol did not differ across BMI categories (26.7% [normal weight], 26.0% [overweight], and 29.2% [obese]; P = 0.11). There were no differences in diabetes treatment among participants with diabetes across BMI groups (69.2% [normal weight], 50.0% [overweight], 55.0% [obese]; P = 0.54), but obese participants with diabetes were less likely to have fasting blood glucose <126 mg/dl (15.7%) compared with normal weight (30.4%) or overweight (20.7%) participants (P = 0.02).


CONCLUSIONS
These findings emphasize the suboptimal rates of treatment and control of CVD risk factors among overweight and obese individuals.
Molenaar
Esther A
EA
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Hwang
Shih-Jen
SJ
Vasan
Ramachandran S
RS
Grobbee
Diederick E
DE
Meigs
James B
JB
D'Agostino
Ralph B
RB
Levy
Daniel
D
Fox
Caroline S
CS
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D017281:Cost of Illness; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight
D000959:Antihypertensive Agents; D008055:Lipids