Why It Might Be Safer to Be Obese

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Many longitudinal studies have reported excess cardiovascular mortality among lean hypertensive subjects, suggesting that obesity may mitigate the cardiovascular risk of hypertension. Available evidence also suggests that in middle-aged and older hypertensive subjects, pulse pressure may be a better predictor of cardiovascular complications. However, there are limited data on the relationship between body mass index (BMI) and pulse pressure.


Using data from the Third National Health and Nutrition Examination Survey we assessed the convergence validity of pulse pressure as a predictor of cardiovascular complications and examined the relationship between BMI and pulse pressure in 1192 older adults with isolated systolic hypertension who were not receiving blood pressure medicine.


There was a good concordance between high pulse pressure and most of the selected cardiovascular risk factors examined in this study. Pulse pressure is higher in the lean (BMI < 25) than in the overweight (BMI > or = 25; 79 mm Hg vs 74 mm Hg, P < .001) and decreases significantly from 82 mm Hg in the first BMI quintile to 76 mm Hg in the fifth BMI quintile. Pulse pressure continues to decrease with increasing BMI until the index exceeds 30.1. This negative correlation persists in a multivariate model with statistical adjustment for age, sex, diabetes mellitus, and hypercholesterolemia.


The inverse relation between BMI and pulse pressure observed here may help to explain previous reports of increased cardiovascular risk among lean versus obese subjects with isolated systolic hypertension.







2 responses to “Why It Might Be Safer to Be Obese”

  1. Jerome Eric Thomas Avatar
    Jerome Eric Thomas

    If one has never experienced “being fit” according to military standards and the energy and flexibility of the body this type of fitness produces. Then this analysis would perhaps be easily/readily acceptable for most common folk. I never knew what fitness was till I went with the US Marine Corps. It was here that I was able to really understand and realize/respect being fit.

    1. David Avatar

      Hey Jerome, good to hear from you! “Fitness” really has many different connotations, but I think, fundamentally, it refers to the ability of a person to respond to his environment in a dynamic manner. There’s some interesting research on the effects of different nutritional and behavioral augmentations for marines, and also how the more elite corps have, on higher, a greater portion of lean body mass and biological markers for high endurance.

      MARSOC CSOs demonstrated significantly greater FFMI, AP, AC, VO2max, KF, KE, TE, and TF compared with enablers.

      These would be optimizations for performance, though, and not necessarily longevity.

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