The association between obesity and the development of hypertension appears to be driven specifically by visceral adiposity, according to research published in the Journal of the American College of Cardiology (2014;64:997-1002).
Alvin Chandra, MD, of the University of Texas Southwestern Medical Center in Dallas, and colleagues followed 903 normotensive participants of the Dallas Heart Study. The study population was 57% female and 60% non-white and had a median age of 40 years and a median body mass index (BMI) of 27.5 kg/m². The median follow-up was 7 years.
On multivariable analysis, each 1 standard deviation increment in BMI was associated with a significant 24% increased relative risk of incident hypertension. When measures of visceral adipose tissue (VAT), subcutaneous adipose tissue, and lower-body fat were included in the model, the only variable that remained independently associated with incident hypertension was VAT.
“It is reasonable health policy at this time to advocate that all obese individuals lose weight via diet and exercise until there is a compelling rationale for any alternate strategy related to regional fat excess,” according to an accompanying editorial.