Stiffening Our Resolve Against Adult Weight Gain

Increasing adiposity with a clinical endpoint of obesity isassociated with a progressive increase in risk of cardiovas-cular diseases (CVD). However, we are only beginning to understand the physiological and pathophysiological mecha-nisms by which excessive body fat storage causes CVD. In this issue of Hypertension, the findings of Wildman et al1 extend and strengthen previous observations2–5 by showing that changes in arterial stiffness, as measured by aortic pulse-wave velocity (PWV), are related to changes in body weight over a 2-year follow-up period in healthy men and women aged 20 to 40 years. Weight gain was associated with an increase, whereas weight loss was associated with a decrease in aortic PWV, independent of changes in blood pressure. The greatest increases in aortic PWV were observed in those subjects who gained the most weight (4.5 kg). Importantly, the changes in aortic PWV were related to changes in body mass index (BMI), indicating that the associations with body weight were mediated by