Blood pressure and cardiorenal responses to anti hypertensive therapy in obese women

Blood pressure and cardiorenal responses to anti hypertensive therapy in obese women

Author Rosa, Eduardo Cantoni Autor UNIFESP Google Scholar
Zanella, Maria Tereza Autor UNIFESP Google Scholar
Kohlmann, Narcia Elisa Bellucci Autor UNIFESP Google Scholar
Ferreira, Sandra Roberta Gouveia Autor UNIFESP Google Scholar
Plavnik, Frida Liane Autor UNIFESP Google Scholar
Ribeiro, Artur Beltrame Autor UNIFESP Google Scholar
Kohlmann, Osvaldo Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: Blood pressure(BP) and target organ responses to antihypertensive drugs are not well established in hypertensive obese patients. This study is aimed at evaluating the effects of obesity and adiposity distribution patterns on these responses. Methods: 49 hypertensive obese women were designated to different groups according to waist to hip ratio measurements - 37 with troncular and 12 with peripheral obesity. Patients were treated for 24-weeks on a stepwise regimen with cilazapril alone or a cilazapril/hydrochlorothiazide/amlodipine combination therapy to achieve a BP lower than 140/90mmHg. Ambulatory blood pressure monitoring (ABPM), echocardiography, and albuminuria were assessed before and after the intervention. Results: After 24 weeks, weight loss was less than 2% in both groups. ABPM targets were achieved in 81.5% of patients upon a combination of 2(26.5%) or 3(55.1%) drugs. Similar reductions in daytime-SBP/DBP: -22.5/-14.1(troncular obesity) / -23.6/-14.9mmHg (peripheral obesity) were obtained. Decrease in nocturnal-SBP was greater in troncular obesity patients. Upon BP control, microalbuminuria was markedly decreased, while only slight decrease in left ventricular mass was observed for both groups. Conclusions: in the absence of weight loss, most patients required combined antihypertensive therapy to control their BP, regardless of their body fat distribution pattern. Optimal target BP and normal albuminuria were achieved in the group as a whole and in both obese patient groups, while benefits to cardiac structure were of a smaller magnitude.
Keywords hypertension
obesity
body fat distribution
anti hypertensive therapy
echocardiography
albuminuria
Language English
Date 2008-02-01
Published in Arquivos Brasileiros de Endocrinologia E Metabologia. Rio de Janeiro, Rj: Sbem-soc Brasil Endocrinologia & Metabologia, v. 52, n. 1, p. 65-75, 2008.
ISSN 0004-2730 (Sherpa/Romeo, impact factor)
Publisher Sbem-soc Brasil Endocrinologia & Metabologia
Extent 65-75
Origin http://dx.doi.org/10.1590/S0004-27302008000100010
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000256344600010
SciELO ID S0004-27302008000100010 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/30401

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