What is the clinical evidence from this study?

Study design: Observational. Population: Obesity (n=536). Intervention: Obesity (High BMI) vs. Normal weight and underweight. Primary outcome: Mean intima media thickness (IMT) of internal carotid arteries (p=<0.01).

What does this research mean for the field?

Obesity is associated with significantly higher mean intima media thickness of internal carotid arteries compared to normal-weight and underweight individuals, an effect that is independent of blood pressure levels. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 1, 2006Open Access

Impact of Obesity in Intima Media Thickness of Carotid Arteries

Q: What are the key findings of this study?

Obesity was associated with significantly higher mean intima media thickness of internal carotid arteries compared with normal-weight (p<0.01) and underweight (p<0.001) subjects.

Q: What does this research mean for the field?

Obesity is associated with significantly higher mean intima media thickness of internal carotid arteries compared to normal-weight and underweight individuals, an effect that is independent of blood pressure levels. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Obesity was associated with significantly higher mean intima media thickness of internal carotid arteries compared with normal-weight (p<0.01) and underweight (p<0.001) subjects.

Study Design

Type

Observational (n=536)

Multicenter

Structured PICO

Does increased BMI (obesity/overweight) increase the intima media thickness of carotid arteries independent of blood pressure levels?

Population

536 subjects (selected from 3,173 consecutive referrals to a Hypertension Center) matched for age, gender, and mean 24-hour BP, with no past or concurrent antihypertensive medication, no concurrent medication with the potential to raise blood pressure, and no secondary causes of hypertension.

Intervention

Obesity and overweight (classified by NIH BMI criteria)

Comparator

Normal weight and underweight subjects

Outcome

Mean intima media thickness (IMT) of internal carotid arteriessurrogate

Obesity is associated with increased carotid intima media thickness independent of blood pressure levels, with fasting serum glucose playing an independently associated role.

Main Result

p-value: p=<0.01

Abstract

OBJECTIVE: To explore differences in intima media thickness (IMT) of the carotid arteries induced by differences in BMI. RESEARCH METHODS AND PROCEDURES: Data from 3173 consecutive subjects, who were referred to our Hypertension Center from 1998 to 2004, were reviewed. Criteria for patients to be considered for further analysis included no past or concurrent antihypertensive medication, no concurrent medication with the potential to raise blood pressure (BP) (e.g., prednisone), and no clinical signs or laboratory evidence of secondary causes of hypertension. Our population was divided into four groups according to NIH criteria for obesity: underweight, normal weight, overweight, and obese. BMI, mean IMT of internal carotid arteries, and 24-hour BP values were available for all subjects. Five hundred thirty six subjects of the four groups, matched for age, gender, and mean 24-hour BP values, were included in the analysis. RESULTS: Mean IMT of internal carotid arteries was increased with increasing BMI. Mean IMT was significantly higher in obese subjects compared with normal-weight (p < 0.01) and underweight (p < 0.001) subjects. Mean IMT was significantly higher in overweight subjects compared with normal-weight ones (p < 0.05). Furthermore, multivariate regression analysis in obese subjects revealed that fasting serum glucose was independently associated with IMT. DISCUSSION: Obesity may be an important factor for carotid atherosclerosis, and at least some of the effects of obesity are independent of the BP levels. Fasting serum glucose levels in obese subjects may play an important role in carotid atherosclerosis.