Obese patients taking drugs to lower blood pressure (BP) and cholesterol levels are less likely to reach recommended targets than their normal weight counterparts, says a new study.
Obesity is associated with high blood pressure, high cholesterol, and diabetes - three well-known risk factors for cardiovascular disease (CVD).
Current Canadian, European, and American guidelines call for lifestyle changes and, if necessary, medication to control these risk factors to reduce obesity-related morbidity and mortality.
Vineet Bhan of the University of Toronto sought to determine whether there were differences in reaching guideline-recommended targets for BP and cholesterol levels, according to body mass index (BMI-height to weight ratio) in individuals deemed at high risk for heart disease and stroke.
“These high risk patients frequently do not reach their blood pressure and cholesterol targets,” says Bhan. “The goal of our study was to see if obesity could be a factor.” he added.
Other studies that have looked at obese individuals in the general population have found they were more likely to have high BP, high cholesterol, and diabetes. The study recruited 7,357 high risk patients who had a history of coronary artery disease, cerebro-vascular disease, diabetes plus additional cardiovascular risk factors from nine Canadian provinces.
This observational study, based on two outpatient registries, took place from 2001 to 2004, recruiting 95 percent of the patients from family physician offices. The registries were led by senior study co-author Shaun Goodman, and coordinated by the Canadian Heart Research Centre.
“Although a direct cause-and-effect relationship cannot be proven, our data would suggest that pharmacologic (drug) treatment alone without achieving optimal weight may not be adequate,” says senior author, Andrew Yan. “This is a potentially important message to get across to clinicians, especially primary care physicians who are on the front line managing these high risk patients in the long term.” the author added.
These findings were presented at the 2009 Canadian Cardiovascular Congress.