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Obesity Paradox Applies to CAD and Hypertension Too

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A team of investigators sought to determine whether such a paradox is also apparent in people with hypertension and coronary artery disease (CAD). The team studied 22,576 people with high blood pressure and CAD who were enrolled in a study of verapamil SR or atenolol (Tenormin, AstraZeneca) therapy for hypertension.

Participants were classified into five groups based on BMI: thin (BMI <20), normal weight (BMI 20–25), overweight (BMI 25–30), class I obesity (BMI 30–35), and class II obesity (BMI 35). Researchers tracked deaths and cases of heart attack or stroke during a 2-year follow-up period.

Compared with people of normal weight, people who were overweight, obese, or very obese were about 24–32% less likely to die or have a heart attack or stroke during the study period. Overweight and obesity may have a protective effect in people with cardiovascular disease, the researchers

Uretsky S, Messerli FH, Bangalore S, et al.: Obesity paradox in patients with hypertension and coronary artery disease. Am J Med 120:863-870, 2007.[Medline]

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