title: Obesity is a strong determinant of hypertensive target organ damage in young-to-middle-age patients.
abstract: OBJECTIVE
  To examine the impact of overweight and obesity on development of target organ damage in the early stage of hypertension.
  
  
  METHODS
  Participants were 727 young-to-middle-age subjects screened for stage 1 hypertension and followed for 8 years.
  
  
  METHODS
  Ambulatory blood pressure (BP), albumin excretion rate and echocardiographic data were obtained at entry, every 5 years and/or before starting antihypertensive treatment.
  
  
  RESULTS
  During the follow-up, hypertension needing treatment was developed by 54.7% of the subjects with normal weight, 66.6% of those with overweight and 73.0% of those with obesity (P<0.001). Kaplan-Meier curves showed that patients with obesity or overweight progressed to sustained hypertension earlier than those with normal weight (P<0.001). At study end, rate of organ damage was 10.7% in the normal weight, 16.4% in the overweight and 30.1% in the obese subjects (P<0.001). In a multivariable logistic regression analysis, overweight (P=0.008) and obesity (P<0.001) were significant predictors of final organ damage. Inclusion of changes in 24-h BP and body mass index, and of baseline organ damage did not virtually modify these associations (P=0.002 and <0.001, respectively). Obesity was a significant predictor of both left ventricular hypertrophy (P<0.001) and microalbuminuria (P=0.015) with an odds ratio (95% confidence interval) of 8.5 (2.7-26.8) and 3.5 (1.3-9.6), respectively.
  
  
  CONCLUSIONS
  These data indicate that in hypertensive subjects obesity has deleterious effects on the cardiovascular system already at an early age. Preventive strategies addressed to achieve weight reduction should be implemented at a very early stage in young people with excess adiposity and high BP.
authors.affiliation: Department of Medicine, Clinica Medica 4, University of Padova, Padova, Italy. palatini@unipd.it
authors.forename: P
authors.initials: P
authors.lastname: Palatini
authors.forename: F
authors.initials: F
authors.lastname: Saladini
authors.forename: L
authors.initials: L
authors.lastname: Mos
authors.forename: E
authors.initials: E
authors.lastname: Benetti
authors.forename: A
authors.initials: A
authors.lastname: Bortolazzi
authors.forename: S
authors.initials: S
authors.lastname: Cozzio
authors.forename: E
authors.initials: E
authors.lastname: Casiglia
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000652:urine*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D003404:Creatinine / Q000652:urine*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D009765:Obesity / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D040242:Risk Reduction Behavior; D015431:Weight Loss
chemical_list: D000959:Antihypertensive Agents; D003404:Creatinine