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Obesity Mutes Favorable Impact of Anti-Hypertension Drug on Remodeling of Left Ventricle: Presented at AHA
By Ed Susman
CHICAGO, IL -- November 16, 2006 -- Obesity appears to mute the favorable impact that antihypertensive drugs have in reversing left ventricular hypertrophy (LVH), researchers said here at the American Heart Association (AHA) 2006 Scientific Sessions.
"Obesity does interfere with the good things these drugs can do," said Eva Gerdts, MD, professor of medicine, Hospital Bergen, Norway, at her poster presentation November 15th.
Dr. Gerdts and colleagues scrutinized the results of the Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) trial, specifically trying to see whether obesity would have an impact on LVH. Treatment with ramipril has been shown to have favorable effects on LVH, returning the shape of the heart towards its normal configuration.
The researchers compared 282 normal weight patients with 399 overweight, 146 obese and 35 morbidly obese patients. At baseline, all 3 of the groups of people who weighed more than normal had statistically larger left ventricular mass.
After an average of 4.8 years of follow up, left ventricular mass decreased in all patient groups. However, while the overweight patients were no longer statistically distinct from the normal patients in the study, those who were obese and morbidly obese still had significantly larger left ventricles, Dr. Gerdts reported.
"We found that in hypertensive patients with echocardiographically-proven left ventricular hypertrophy, obesity is associated with less cardiac benefit from antihypertensive treatment; less reduction in left ventricular hypertrophy, less improvement in left ventricular systolic function, higher cardiovascular mortality and a higher incidence of new-onset diabetes," she said.
Overweight and obese patients had a 2- to 3-fold increased risk of cardiovascular mortality compared with normal weight patients, Dr. Gerdts said. Morbidly obese patients were 6-times more likely to die than normal weight individuals, she said.
[Presentation title: Impact of Overweight and Obesity on Changes in Left Ventricular Structure and Function During Losartan- or Atenolol-based Antihypertensive Treatment (the LIFE study). Abstract 3624]
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