An International Journal for Biomedical Sciences - Biomedicine

Modification of life style: Hypertension in Obese
has shown to be independent risk factor for the
development of hypertension. Several large
epidemiological studies have documented the
association between body weight and blood
pressure(7,8). The relationship between body
mass index and blood pressure was studied
in 25-60 years of age, in a sample from urban
population. In this study, BMI & WHR were
significantly associated with systolic and
diastolic blood pressure and was independent
of age, sex, lifestyle, dietary intake and sodium
and potassium excretion. In a recent, updated
evolution of the Nurses Health Study, a longterm
follow-up study of more than 80,000
female nurses, BMIs at 18 years of age and
middle age were positively associated with the
occurrence of hypertension(9). Long-term and
medium term weight loss was associated with
a reduced risk in the group of women with a
high baseline BMI. A central fat distribution is
a better predictor for hypertension than overall
fat mass. Earlier studies have shown a good
correlation between the Weight/Height Ratio (
WHR)and blood pressure levels(10,11). Later
studies using computed tomography to measure
to exact amount of visceral adipose tissue
showed strong correlation with systolic and
diastolic blood pressure levels both in European
and African population (12-15).
Life style modification and Physical activity
Importance of lifestyle modification can
be addressed by the fact that most of the
community physicians in India who were
treating hypertension have no time to tell the
patients regarding lifestyle modifications.
The low level of physical activity of individuals
demanded by modern life, therefore, has
created a condition that has made dietary
intake a more noticeable component of obesity
risk than it ever was before. A further lifestyle
change is the daily stress to which human are
exposed. There are different physiological
responses to stress. The so-called “fight or
flight” response involves stimulation of the
10
sympatho-adrenal system, and this response
has been implicated in hypertension. Increase
in aerobic physical activity such as brisk
walking, jogging, swimming or bicycling has
been shown to lower blood pressure. This
reduction is independent of weight loss(16). A
meta-analysis of 54 randomized control trials
show a net reduction of 3.8 mm Hg in systolic
and 2.6 mm Hg in diastolic blood pressure
in individuals performing aerobic exercise.
Compared to controls, physical activity reduces
systemic vascular resistance due to decreased
sympathetic and nervous system activity. This
is evidence by lower plasma nor-epinephrine
level in exercising individuals as compared to
sedentary people(17).
Dietary salt intake
Food intake in humans is by nature, very poorly
controlled. There has never been any real
evolutionary pressure to suppress the appetite.
In fact, it is quite the opposite. Because man
is a hunter-gatherer and because of the annual
cycles of “feast and famine” the evolutionary
drive has been to seek food constantly, to gorge
when it is readily available, and to be able to
survive periods of famine.
Our studies have indicated in this respect the
total caloric (carbohydrates, fats, protein and
minerals) intake was more than prescribed RDA.
Raised BMI and WHR of the experimental
group therefore may be a result of over nutrition
leading to a highly fed state. The total caloric
intake was much high in the Indian obese almost
by 132.21 percent their control counterparts.
Therefore the of total caloric intake is a major
and main contributor towards the increase in
body weight and hypertension in India. In these
days of increasing economic status it has
resulted in a higher consumption of sugar, salt,
meat and saturated fatty acids amongst Indians
and therefore has increased the possibility
of obesity with blood pressure. Dietary salt
intake in associated with blood pressure.
Epidemiological , clinical , experimental and
www.biomedicineonline.org Biomedicine - Vol 31; No.1: 2011