Overweight and obesity in the Spanish population was shown to be related to high rates of uncontrolled hypertension and associated with a high prevalence of cardiovascular (CV) risk factors and morbidity. The cross-sectional, multicenter survey was conducted in general practice in Spain and reported by Prof. O.Gonzalez Albarran, Madrid, Spain, at the 17th European Meeting on Hypertension, held in Milan from June 15 to June 19, 2007.

The survey included 2,089 overweight persons (mean age 62 years, 51% men, BMI 25-29.9) and 2,552 obese persons (mean age 62 years, 45% men, BMI ≥ 30). All were being treated for hypertension. Blood pressure was evaluated with a cuff adapted to the arm circumference. Glomerular filtration rate was estimated by the MDRD equation.

In the overweight persons, waist circumference (cm) was 94.2 in women and 101.5 in men, and the mean blood pressure was 143.4/83.8 mmHg. In the obese persons, waist circumference (cm) was 107.9 in women and 113.6 in men, with a mean blood pressure of 145.5/85.1 mmHg

In the persons without diabetes, uncontrolled hypertension (<140/90 mmHg) was significantly higher in the obese compared to the overweight persons (73.1% vs 66.7%, respectively). In those with diabetes, uncontrolled hypertension (<130/80 mmHg) was also significantly higher in the obese compared to the overweight (93% vs 90%, respectively). Severe hypertension (≥ 180/110 mmHg) was identified in 6.3% of the obese and 5.3% of the overweight persons.

Step 1 hypertension was identified in 43.3% of the diabetics and 42.2% of the non-diabetics, Step 2 hypertension in 20.2% and 20.4% respectively, and 5.3% of the diabetics and 6.2% of the non-diabetics.

All CV risk factors were significantly higher in the obese persons (waist circumference ≥ 88 cm in women, ≥ 102 cm in men). Abdominal obesity, as measured by waist circumference was identified in 80.2% of women and 92.8% of men, dyslipidemia in 49% and 55.3% of women and men, and type 2 diabetes in 26% and 37% of women in men, both respectively.

CV morbidity was also high in relation to overweight and obesity, as shown in the Table. A positive association was identified between ischemic heart disease and heart failure (p:0.01) and a 1.6% higher risk of heart failure in the persons with obesity compared to overweight.

Overweight Persons Obese Persons
Left ventricular hypertrophy (%) 11 16
Ischemic heart disease (%) 10.2 11.3
Heart Failure (%) 5.6 8.7
Glomerular filtration rate (<60 ml/min/1.73m2) (%) 40 45