Risk factors for hypertension in obese women. The role of weight cycling

Abstract

Objective: To study signi®cant factors associated with the risk of hypertension among obese women, with and without a history of weight cycling (WC). Design: Case ± control study. Setting: Obesity Clinic of Chieti University, Italy. Subjects: A group of 258 obese women aged 25 ± 64 y (103 cases with hypertension and 155 controls) were recruited. All obese subjects had the same clinical characteristics, were without a family history for hypertension, were non-smokers, had normal lipidemic pro®les and normal glucose tolerance, were not taking any medication and were otherwise healthy. Intervention: In the weight cycling women, the history of WC was established on the basis of at least ®ve weight losses in the previous 5 y due to dieting, with a weight loss of at least 4.5 kg per cycle. A logistic regression model adjusted for confounding variables such as waist-to-hip ratio (WHR) and weight cycling history parameters was used and the odds ratio (OR) with 95% con®dence intervals was calculated. Results: The risk of hypertension increases in subjects with larger WHR (OR 7.8; 95% CI 3.4 ± 17.9) and with a positive history for WC (OR 4.1; 95% CI 2.4 ± 6.9). Further, in obese patients with WC, the weight cycling index and the sum of the weight regained are also important risk factors for hypertension. Conclusions: These ®ndings could support the hypothesis that it is the combined exposure of central-type obesity and WC that strongly raises the risk of hypertension. Sponsorship: This work has been ®nancially supported by a grant

Weight fluctuations and risk for metabolic syndrome in an adult cohort

“…Consistent with other studies, we found no interaction between WF and weight change on the risk for MS or each MS component. 10,[31][32][33] There are a number of previous studies that have investigated the relationships between WF and each individual component of the MS. 10,[31][32][33][34][35][36][37] In our study, we found that WF had an increased risk for BP, HDL-c and WC. ORs for the fasting blood glucose and TG components followed the same trend and we assume that their nonsignificant results were related to insufficient statistical power (the number of cases was smaller than those for other components).…”

“…These results are in agreement with some previous analyses. WF over time was associated with an increased risk of hypertension in obese subjects in a study investigating the effect of short-term weight change using a 2-year weight cycling period 36 (results also confirmed with a 5-year period of WF estimation 34 ). WF was also associated with an increased body fat mass, BP and TG level in nonobese young women in an intervention study testing the effect of the succession of intentional weight cycling during a 6 months follow-up period.…”

Body fat distribution of overweight females with a history of weight cycling

“…26,27 Interestingly, a highly significant correlation between BMI and WHR was found only in weight cyclers but not among nonweight cyclers. 26 In contrast, no adverse effects of weight cycling on body fat distribution were found by other authors.…”

“…18,25 It has been suggested that the adverse effects of weight cycling could be due to a redistribution of body fat to the upper body compartments. 26,27 In turn, an upper body obesity strengthens the risk of the 'Metabolic Syndrome', a constellation of metabolic diseases including dyslipidemia, insulin resistance, hypertension and its clinical consequences like cardiovascular disease and fatty liver. 1,2,28,29 Imaging techniques, that is, magnetic resonance imaging (MRI), computer tomography (CT) and dual-energy X-ray absorptiometry (DEXA), are precise and accurate techniques used to study lean body mass and adipose tissue distribution.…”

Associations of short-term weight changes and weight cycling with incidence of essential hypertension in the EPIC-Potsdam Study

“…[12][13][14] To our knowledge, the impact of short-term weight loss on the risk of hypertension has not been estimated in observational studies. With respect to the association between weight cycling and risk of hypertension, a positive relation was detected in a study group of obese women, 15 but no association was reported in a population of female nurses 13 and in a group of nonobese blue-collar workers. 16 The few studies examining weight cycling and risk of hypertension suggest differential effects of weight cycling depending on body weight status, in that weight cycling may present a risk factor for hypertension among obese subjects and may not influence the hypertension risk among non-obese people, but evidence is limited and requires further investigation.…”