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Antihypertensive treatment, adiponectin and cardiovascular risk

Journal of Human Hypertension volume 21, pages 8–11 (2007)Cite this article

Hypertension is a well-established risk factor for vascular disease, with wide-ranging implications on morbidity and mortality, and endothelial damage/dysfunction, inflammation, insulin resistance, platelet activation and changes in the coagulation cascade leading to a prothrombotic state being some of the many underlying pathological processes responsible for the progression of atherosclerosis and the increase in cardiovascular risk.1

Current principles of antihypertensive treatment aim, in addition to lowering blood pressure to halt the progression of atherosclerosis and alleviating the risk of cardiovascular events. Focus has therefore been directed on developing and improving antihypertensive treatment strategies with effects beyond mere blood pressure control, apart of strategies to comprehensively address the overall cardiovascular risk in a holistic manner.2 In particular, obesity has been identified as a major contributor to many aspects of overall cardiovascular risk.3 However, some caution is needed in interpreting studies that address this relationship, if body-mass index (BMI) is used as a criterion for obesity. One interesting systematic review of 40 studies with 250 152 patients found that patients with a low BMI (i.e., based on a BMI definition of <20 kg/m2) had an increased relative risk (RR) for total mortality (RR 1.37), and cardiovascular mortality (RR 1.45), whereas obese patients had no increased risk for total mortality or cardiovascular mortality. In contrast, patients with severe obesity (⩾35 kg/m2) did not have an increase in total mortality (RR 1.10) but they did have an increase in cardiovascular mortality (RR 1.88).3

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  1. University Department of Medicine, Haemostasis, Thrombosis and Vascular Biology Unit, City Hospital, Birmingham, UK

    V J Karthikeyan & G Y H Lip

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  1. V J Karthikeyan
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Correspondence to G Y H Lip.

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Karthikeyan, V., Lip, G. Antihypertensive treatment, adiponectin and cardiovascular risk. J Hum Hypertens 21, 8–11 (2007). https://doi.org/10.1038/sj.jhh.1002113

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