Therapeutic Considerations in the Treatment of Obesity Hypertension

Marion R. Wofford, MD, MPH; Margaret Miller Davis, MD; Kimberly G. Harkins, MD; Deborah S. King, PharmD; Sharon B. Wyatt, PhD, RN, CS; Daniel W. Jones, MD

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Obesity: An Epidemic

The increasing prevalence of obesity in the industrialized world is an alarming epidemic. Despite a national health objective to decrease the prevalence of obesity in the United States,[4] recent studies have estimated that 55% of the US population greater than 20 years old is overweight or obese, defined as 20% more than ideal weight (i.e., the ideal weight for a 5'5" woman is about 125 lbs.; she is obese if her weight exceeds 150 lbs.). This represents an 8% increase in the last 10 years.[5] The increase in obesity is seen in all racial/ethnic, gender, and age groups. According to National Health and Nutrition Examination Survey (NHANES) data,[6] an estimated 60.6% of white men and 56.7% of African American men are overweight or obese; 47% of white women and 65.9% of African American women are overweight or obese. The increase in prevalence of overweight in the last 10 years is almost entirely due to an increase in the prevalence of frank obesity.[6]

The nature of health risks related to overweight and obesity is similar in all populations. The level of risk associated with a given level of overweight or obesity, however, may vary with race/ethnicity, age, gender, and societal conditions. For example, dietary factors may predispose individuals to higher risk at a given age group. Morbidity for a number of health conditions increases as body mass index (BMI) increases above 20 kg/m2.[7]

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