Strong association of overweight to high blood pressure in a rural community of central Italy: the 'Di.S.Co.' Project

Relation between overweight, diabetes, stress and hypertension: a case-control study in Yarumal--Antioquia, Colombia

AIMS

The aim of this study was to assess the association between overweight, diabetes, stress and other postulated risk factors for a high blood pressure, on the risk of hypertension.

METHODS AND RESULTS

This matched case-control study included 228 cases randomly selected in a rural adult population in Yarumal--Antioquia, Colombia. For every case, one control, individually matched by age (+/- 5 years), sex and residence, was selected from the general population. Conditional logistic regression was used to estimate odds ratios (OR). Obese people (body mass index (BMI) > or = 30 kg/m2) showed an increased OR of hypertension compared to those with a BMI < 25 kg/m2, OR: 3.83 [95% confidence interval (CI): 1.83-8.00]. A high level of psychological stress was associated with hypertension (measured on a tension-anxiety scale), OR: 5.02 (95% CI: 2.25-11.19). A positive association was also observed for diabetes although it was of borderline significance, OR: 2.58 (95% CI: 0.88-7.55). Having a family member with hypertension or myocardial infarction was related to a higher risk of hypertension (p < 0.05).

CONCLUSIONS

This study provides evidence that BMI, stress (feelings of anxiety or tension), and diabetes are independently associated with an increased risk of hypertension in a rural area of Colombia.

Comorbidities of overweight and obesity: current evidence and research issues

PURPOSE

The evidence with regard to the relationship of obesity with medical comorbidities was assessed and priority research issues identified.

METHODS

The existing literature in English was surveyed.

RESULTS

The evidence is overwhelming on the association of obesity to a number of medical conditions. These include: insulin resistance, glucose intolerance, diabetes mellitus, hypertension, dyslipidemia, sleep apnea, arthritis, hyperuricemia, gall bladder disease, and certain types of cancer. The independent association of obesity seems also clearly established for coronary artery disease, heart failure, cardiac arrhythmia, stroke, and menstrual irregularities. The relationship between central (or upper body) obesity and the above conditions is positive for most of them but with a lesser number of studies. Most of the fat distribution studies have been done using anthropometric measurements rather than the more accurate magnetic resonance imaging or computer tomographic scans. Priority research issues include the following: more definitive data on the relation of central fat to comorbidities; the proportional importance of subcutaneous versus visceral fat in producing comorbidities; the relationship between obesity and psychiatric disease; the genetics of the relationship between obesity and each of the comorbidities; the independent contribution of diet and of sedentariness to the development of each of the comorbidities; the impact of gender, race, intensity, and duration on these associations.

CONCLUSIONS

The evidence for the relationship of obesity to a number of comorbidities is strong, though the strength of the relationship varies with the condition. Much more research is necessary on causation and on what other factors may play an interactive role.