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Chandni Patel HSC 4730 November 26, 2013

The Association between Obesity and Hypertension in Young Adults Introduction Obesity has been a growing public health problem for over a decade and has been on a rise since then. It has emerged to become a serious problem around the world. Obesity is a global problem that is prevalent in many societies. This disease is associated with a host of maladies such as hypertension. Zhao, Ford, and Li and Mokdad (2009) stated that 57.8% of those participants with hypertension that tried to lose weight were significantly higher than 50% of those with no condition. Hypertension is a chronic medical condition in which the blood pressure in the arteries in elevated. It can be a silent killer because sometimes an individual will not have symptoms or could be unaware of their blood pressure level. Among 78,446 participants who tried to lose weight, 23% of those with hypertension and 28% of those with both hypertension and diabetes, reported adopting a low fat-low- calorie diet in controlling their weight, significantly higher than 19% of those with neither disease (Zhao et al, 2009; Mokdad, 2009). Finally, two-thirds of patients over 40 who were 10 pounds or more over-weight had elevated blood pressure; 49% of those 10% or more underweight or more with low systolic pressure of 110 mm Hg or less; 18% of those overweight had high systolic blood pressure over140 1

mm HG (Mokdad, 2009). In 2010, no state had a prevalence of obesity less than 20% (Mokdad,1999). Thirty-six states had prevalence of obesity equal to or greater than 25%; 12 of these states had prevalence equal to or greater than 30% (Mokdad, 1999). Obesity has only increased in the past few years. It has also has increased the chances of many chronic diseases, which can lead to hypertension in many young adults. Research undertook this project to provide public health practitioners up-to-date information on obesity and its effects. Also, current studies do not emphasize how important this issue has become in the last ten years. There is little known about weight control behaviors among overweight adults with hypertension, because some people are more likely to keep their health issues to themselves. Nowadays, society depends heavily on mass media. Most people are not financially well set, have trouble finding time for them, or underestimate their health care. In addition, people have started to rely on medications rather than performing physical activities and making healthier food choices. In Mokdads (2009) study, there was a gap due to all of the states in North America not participating. In a study, there should be more emphasis on the effects obesity has on an individuals and how this study can benefit an individual personal health. Furthermore, it is difficult to conclude if the population is too large. However, from the findings of these studies we can conclude that obesity and hypertension should be a cause to look at and find a way to lessen the chances of obesity and its effects. Obesity and hypertension are major problems that need more attention, so it can be prevented from ones life. Thus, the purpose of this review is to synthesize the literature on intervention studies that seek to reduce hypertensive symptoms among obese adults.

Methodology The databases used for this research are PubMed, and also the University of North Florida OneSearch. For this research, the articles are required to include the following parameters: published after 1990, full text available, and adults. While searching for these articles some key words/ MeSH terms are used such as obesity, AND hypertension, AND young adults, AND in United States. For this research to be accurate, the results had to be English, peer-reviewed, has a minimum sample of twenty people, and fulllength articles. The results excluded are non-English, abstract only and less than two pages. For the results matrix the following information: author, sample size, outcome, and overall support are extracted from all included articles.

Results Table 1 Association between Obesity and Hypertension Author


Ford et al. (2008)

Sample size
There were 4,990 participants with hypertension in the National Health and Nutrition Examination Surveys 3,644 participants in NHANES II and 3,554 participants in HANES III.

Intervention/ Exposure
The experimental control group was the group with obesity and hypertension. The control group was the group with nonhypertension.

Outcome
Among with hypertension, obesity increased from 25.750.8%. Among the adults without hypertension, obesity increased from 8.425.1%.

Overall Support
People with hypertension are currently obese and are currently working with their clinicians in managing their weight and hypertension.

Fuemmeler et al. (2011)

Mokdad.(1999)

The study population consisted of 15,197 participants from the National Longitudinal Study of Adolescent Health The study population consisted the United States.

The experimental group examined the odds of overweight and hypertension. The experimental group was obesity and the risk such as hypertension.

There is a direct link between obesity and hypertension in later life There were ten stated that were prevalence of obesity less than 10% and no states had prevalence equal to or greater than 15%. Survey participants classified as abdominally obese had almost 50% increased odds of being hypertensive There were 58% of the participants with hypertension and tried to lose weight had a significant results in their blood pressure results.

Hypertension can be associated with health behaviors

The rate of obesity increased and caused many cardiovascular diseases, which included hypertension. The obesity is independently associated with hypertension

Ostchega et al. (2012)

There were a total of 17,170 participants, who were 18 and older sampled. From these participants, 12,755 were interviewed and 12,355 were examined. There were 143,386 overweight/obese participants in the 2003 Behavioral Risk Factor Surveillance System.

The experimental group examined the obesity and hypertension being independent or dependent. The study examined the proportion of overweight adults who tried to lose weight and their weight control strategies by hypertension and/or diabetes status.

Zhao et al. (2009)

The obese patients with diagnosed hypertension who attempted to lose weight remains poor and the weight control strategies varied significantly

In Fords (2008) study, adults ages18 to 74 years of age participated in the National Health and Nutrition Examination Surveys. Four thousand nine hundred ninety participants had hypertension in NHANES II, 3,644 participants in NHANES III and 3,554 participants in NHANES 1999-2004. The experimental control was obese individuals with abdominal obesity with hypertension and the control group was the group with non-hypertension. People with hypertension are currently obese and are currently working with their clinicians in managing their weight and hypertension. In (Ostchega, Hughes, Fakhouri, and Miller, 2012) study, there were a total of 17,170 participants, who were 18 and older sampled. From these participants, 12,755 were interviewed and 12,355 were examined. Obesity is independently associated with hypertension because it shows an increase after controlling the BMI. The studies among each other were very similar because the obesity leads into hypertension. There is positive correlation among both obesity and hypertension because the more obese an individual, the higher the hypertension level is. In (Fuemmeler,Ostbye,Yang, and McClernon,2011) study, 15,197 young adults, were examined the odds of overweight and obesity and hypertension. There is a direct link between obesity and hypertension in later life. In Zhao et als (2009) study, there were 143,386 adults who were obese. Among all the participants, there were 58% of the participants with hypertension and tried to lose weight had a significant results in their blood pressure results. In Mokdads (1999) study there were ten states that had a prevalence of obesity less than 10% and no states had prevalence equal to or greater than 15%. As the years went on, the rate of obesity increased and caused many cardiovascular diseases, which included hypertension. 5

Discussion The purpose of my systematic literature review was to analyze if obesity can lead to chronic cardiovascular diseases in young adults such as hypertension. All the studies have shown to have similar results of showing that obesity does lead to hypertension. Many of the young adults disregard the effects obesity has on their future health, which can lead to developing chronic diseases. People with hypertension are currently obese and are currently enrolled with their clinicians to manage their weight and lower hypertension (Ford et al., 2008). Hypertension can be controlled by physical activities and healthy dietary intake and also help reduce the chances of obesity (Fuemmeler et al., 2011). Losing weight can help prevent many of the chronic cardiovascular diseases and also reduce obesity in young adults. There were several limitations in my reviews. One of the limitations in my review was that all measurement such as weight control behaviors, disease status and BMI used in the review can be biased. Another limitation in my review was that my review was not thorough in depth and complete. Public health practitioners can use the results of my review to improve health among my target population in many ways. One way public health practitioners can improve health among young adults is by encouraging them to do more physical activities such as running for thirty minutes three times a week. Secondly, public health practitioners can provide information on in taking healthier foods. Finally, public health practitioners should encourage young adults to go get their physical examination every six months or yearly. In summary, obese patients with hypertension need more attention from healthcare to set appropriate behavioral goals for weight loss.

Health care educators can provide appropriate education to promote effective weightloss strategies to patients.

References Ford, E., Zhao, G., Li, C., Pearson, W., & Mokdad, A. (n.d). Trends in obesity abdominal obesity among hypertensive and nonhypertensive adults in the United States. American Journal of Hypertension, 21(10), 1124-1128. Fuemmeler, B. F., stbye, T. T., Yang, C. C., McClernon, F. J., & Kollins, S. H. (2011). Association between attention-deficit/hyperactivity disorder symptoms and obesity and hypertension in early adulthood: a population-based study. International Journal of Obesity, 35(6), 852-862. doi:10.1038/ijo.2010. Mokdad AH.(1999). The spread of the obesity epidemic in the United States, 1991-1998. JAMA. 1999; 282:16:1519-22.Retrieved from http://www.cdc.gov Ostchega, Y., Hughes, J., Terry, A., Fakhouri, T., & Miller, I. (2012). Abdominal obesity, body mass index, and hypertension in US adults: NHANES 2007-2010. American Journal Of Hypertension, 25(12), 1271-1278. doi:10.1038/ajh.2012.120 Zhao,G., Ford, E., Li,C., and Mokdad, A.(2009,March 06). Weight control behaviors in overweight/obese U.S. adults with diagnosed hypertension and diabetes. BioMed Central.8:13.doi: 10.1186/1475-2840-8-13