Researchers from The University of Western Australia and the Royal Perth Hospital Medical Research Foundation are warning that Australia’s obesity epidemic is undermining expert attempts to reduce cardiovascular disease.

Cardiovascular disease is the leading cause of death worldwide, affecting 6 million Australians. It is directly linked to 27 percent of deaths in Australia each year. Almost a third of Australians currently have high blood pressure, but only half of them are aware of it.

To examine the relationship between obesity and hypertension, The Dobney Hypertension Centre (a joint venture between the RPH Research Foundation, Royal Perth Hospital and The University of Western Australia) is looking for patients who are obese and have hypertension to participate in a new clinical trial.

UWA Professor Markus Schlaich, who holds the Dobney Chair in Clinical Research at the Royal Perth Hospital Medical Research Foundationsaid being overweight or obese could cause high blood pressure and also worsen for people who already had the condition.

“Studies have already shown a correlation between weight gain and blood pressure,” Professor Schlaich said.

“This is very concerning when you consider that it is projected that 75 percent of women and 83 percent of men, who live in industrialized countries like Australia and the U.S., will be obese by 2025. Statistics indicate that 60 to 70 percent of hypertension diagnoses may be directly attributable to obesity.”

UWA lead researcher Dr. Revathy Carnagarin said more research was needed to better understand how to treat high blood pressure in obese patients.

“This is because many of the current approaches don’t address the unique complications caused by being both overweight and hypertensive,” Dr. Carnagarin said.

“Obesity-related hypertension (OHT) is a complex disorder and current hypertension guidelines do not provide specific recommendations for treating it.

“Some medications have even been shown to be less effective in obese patients. As such, combinations of various pharmacologic, blood pressure lowering approaches are particularly required in the management of obesity-related hypertension.”

Dr. Carnagarin said obesity could trigger a complex chain of events in the human body that elevate blood pressure. This includes obstructive sleep apnea, impaired kidney function, insulin resistance, glucose intolerance and increased sodium sensitivity and reabsorption.

While weight loss and exercise are still at the forefront of tackling obesity and obesity-related hypertension, Dr. Carnagarin said they did not always produce the desired results.

“In addition, most patients fail to implement and sustain the appropriate lifestyle changes long term,” Dr. Carnagarin said.

“Achieving long-term weight loss and lowering blood pressure needs lifestyle changes as well as blood pressure drug therapy.”

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Malnutrition involves consuming nutrients that are either too much or not enough in a way that it causes health problems. The health issue has been a longstanding predicament worldwide, and now, a new study shows that a third of the poorest countries in the world are facing high levels of obesity, as well as undernutrition.

The study, which was published in The Lancet,highlights the worldwide problem of malnutrition, whether it may be obesity or undernourishment, which leads to various health problems. The study also sheds light on common factors contributing to malnutrition, such as global access to ultra-processed foods and less physical activity.

Rapid changes in food systems

Further, the researchers reiterate that a new approach is required to help reduce undernutrition and obesity at the same time since both issues have become increasingly tied due to fast changes in the world’s food choices. The issue is rampant specifically in low- and middle-income countries.

Malnutrition and obesity can drive many effects since they are tied to poor health in children as well as adults. Due to the speed in changes in food systems, more people face problems with both types of malnutrition throughout their lifetime. With the exposure to extremes of malnutrition, it magnifies many harmful health effects.

The modern food systems prevent such countries and people living in it to consume safe, cheap, and healthy diets, which are sustainable and accessible,

Malnutrition by the numbers

There are about 2.3 billion children and adults who are overweight across the globe. Among children, an estimated 150 million are stunted or having prevented from developing or growing properly. The study also explored the trends behind the connection, known as the double burden of malnutrition.

In the study, one in three of such countries had overlapping types of malnutrition (45 of 123 countries in the 1990s, and 40 of 126 countries in the 2010s), specifically in South Asia, East Asia, sub-Saharan Africa, and the Pacific.

More alarming findings show that more than 15 percent of people had wasted, more than 20 percent of women were too thin, while more than 20 percent of people were overweight, and 30 percent of children had stunted growth, according to the survey data conducted by the group from low- and middle countries in the 1990s and 2010s.

Further, about 14 countries in the 2010s with the lowest incomes across the globe had recently had a double burden of malnutrition compared to what they were in the 1990s. The results also show that fewer of third world countries with the highest incomes were impacted.

The researchers added that the availability of ultra-processed foods has been linked to weight gain, which affects mostly infants, toddlers, and preschoolers. Such changes include the lack of availability of fresh food markets and the increasing access to supermarkets.

Also, the trend of being undernourished early in life followed by becoming obese or overweight from childhood and in the future may be associated with a higher risk of developing chronic diseases or non-communicable diseases, including hypertension, cardiovascular disease, stroke, and type 2 diabetes.

The journal has three other related-papers that build on the first paper’s work, exploring the double burden of malnutrition and its health impacts.

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Washington: In a recent study it has been found that the fear and worries associated with deportation may have negative impacts of developing high blood pressure over a four-year period. The study was published in the journal, ‘JAHA: Journal of the American Heart Association.’ In a four-year study of Mexican-born women who reside in an agricultural area of California, the worry of deportation appears to double their risk of developing high blood pressure.

The researchers followed 572 women (average age of 39 years; 99 per cent were born in Mexico) participating in a long-term study of Mexican women and their children in farmworker families in the Salinas Valley region of California.

“Our findings suggest that concerns around immigration policies and enforcement may have potentially negative impacts on the long-term cardiovascular health of immigrants and their families and community,” said Jacqueline M. Torres, lead author at the University of California, San Francisco.

As part of a baseline assessment in 2012-2014, the women in the study were asked to rate their concern about deportation for themselves or others as not too much (28 per cent), a moderate amount of worry (24 per cent) or a lot of worries (48 per cent). At the baseline assessment, worry about deportation was associated with steeper increases in systolic (top number) blood pressure. However, there was no significant difference in the proportion of women diagnosed with high blood pressure.

“Given what we learned in this first study, we are concerned about the long-term effects of deportation worry and its impact on both mental and physical health,” Torres said. In the four-year, follow-up with evaluations conducted between 2014-2016 and 2016-2018, the researchers found:

A steeper initial increase in systolic blood pressure and mean arterial pressure in women who reported higher deportation worry at their baseline assessment;

No change in the association between deportation worry and higher body mass index (BMI) and waist circumference over four-years; and

Among the 408 women who did not have high blood pressure at the initial assessment, women with moderate or high deportation worry were twice as likely to be diagnosed with high blood pressure, compared to those expressing little worry during the four-year follow-up period (either self-reported, a formal diagnosis or a blood pressure greater than 130mm Hg systolic or 80 mmHg diastolic at the evaluation).

“Just as clinicians may think about the role of other stressors impacting the lives and health of their patients, this study suggests they may also need to consider the impact of policies such as immigration on stress levels and the subsequent effect on outcomes related to blood pressure,” explained Torres.

The researchers cautioned that the study contained only women from one part of the country, and the results may not be generalisable to other groups. However, they noted there is also reason to believe they may have underestimated the effect that living in fear of deportation has on cardiovascular risks like high blood pressure.

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