Does hypertension influence effectiveness of weight reduction therapy in patients with simple obesity?

Abstract

Background The aims of the study was to evaluate of relationships between co-existing hypertension and effectiveness of non-pharmacological interversion in simple obesity. Material and methods The investigated population consisted of 2 groups matched for age and gender: group 1 - simple obesity (n = 43), group 2 - obesity and mild to moderate treated hypertension (n = 52). Diabetes and other severe diseases were excluded. On the base of assessed body weight, height, waist and hips circumferences body mass index and waist to hip ratio were calculated. Visceral obesity was defined as waist circumference > 102 cm in males and > 88 cm in females. Fasting lipids (TCh, HDL, LDL, TG) were evaluated by commercial enzymatic test. During oral glucose tolerance test 0, 60, 120 min blood glucose and 0, 120 insulin (IRMA, PL) were taken. HOMA index was calculated as a measure of insulin resistance. After 12 months of individual reduction diet and increased physical activity the examination was repeated, and absolute and relative changes of investigated parameters were determined.
Results Arterial hypertension has 1.3 times more often appeared in patients burdened with the visceral obesity in relation to the group with the gynoid obesity. Significantly elevated waist circumferences, waist to hip ratios, fasting and post load plasma glucose and insulin, HOMA index and lower HLD cholesterol were characteristic features of group 2 in comparison to group 1. Patients with the pure obesity are characterized by a significantly larger percentage of persons who reached essential (over 10% or 5-10%) reduction in the body weight. In comparison to patients with gynoid type of obesity of group 1 patients with abdominal distribution of fat of group 1 and patients of group 2 were characterized by increased fasting and post charge insulin and HOMA index (p < 0.05). Despite body weight falls do not differ in two examined groups, markedly enhanced BMI reduction and percentage reductions of body mass and BMI were observed in pure obesity. Significant, proportional to weight reduction, decrease in waist, and hip circumferences was observed in both groups. In group 2 significantly greater reduction in systolic blood pressure was noted. In both groups marked reductions in 60 min glucose, 120 min insulin, HOMA index, total cholesterol, LDL, HDL were observed; fasting glucose additionally in group 1. In comparison group 1 was characterized by augmented fall of fasting glucose and diminished - of HOMA index.
Conclusions
1. Patients with obesity-combined hypertension have the enhanced number of cardiovascular risk factors and visceral obesity.
2. Coexisting hypertension aggravates weight reduction in obesity probably due to accompanied and abdominal distribution of fat and hyperinsulinaemia/insulin resistance.
3. Even the little reduction in the body weight results in significant improvement in metabolic and clinical disorders co-existing with obesity.
Arterial Hypertension 2010, vol. 14, no 3, pages 177-188