Clinical research studyObesity Paradox in Patients with Hypertension and Coronary Artery Disease
Section snippets
Study Design
INVEST was a prospective, randomized, international study of 22,576 patients with hypertension and coronary artery disease. The inclusion and exclusion criteria, study design, and results have been published elsewhere.19 In brief, eligible patients were randomized to a verapamil-SR–based or an atenolol-based treatment strategy to achieve the Sixth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure targets (<140/90 mm Hg or <130/85 mm Hg in those
Baseline Characteristics
The mean age was 66 ± 9.8 years, and the mean follow-up was 2.7 years (range, 1 day to 5.4 years) with 61,835 patient years accumulated. Of the 22,572 patients included in this analysis, 2.2% were thin, 20.0% were normal weight, 39.9% were overweight, 24.6% had class I obesity, and 13.2% had class II to III obesity. Pertinent baseline characteristics by BMI class are summarized in Table 1. Compared with normal-weight patients, overweight and class I to III obese patients were younger, had a
Discussion
This study addressed the effect of BMI on cardiovascular outcomes in a cohort of patients with hypertension and coronary artery disease. Our study is in agreement with previous studies that observed an obesity paradox in patients with previous cardiovascular disease.
Conclusion
In this well-treated hypertensive cohort with coronary artery disease, increasing BMI was associated with decreased morbidity and mortality when compared with normal-weight patients, consistent with an “obesity paradox.” Whether this relationship is the result of the shortcomings of BMI as a risk factor needs to be further elucidated.
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