Last Updated: 2002-11-14 16:00:03 -0400 (Reuters Health)

By Merritt McKinney

NEW YORK (Reuters Health) - New research suggests that obesity itself damages blood vessels, even in the absence of high blood pressure and other known risk factors for artery disease.

In a study of middle-aged Italian women, obesity was directly related to thickening of the carotid arteries, the large vessels in the neck that deliver blood to the brain. Such thickening increases the risk of stroke and is an early sign of disease in other arteries, including those that supply the heart.

According to the study's lead author, Dr. Paolo Rubba at Federico II University in Naples, Italy, it has been thought "that obesity in itself is not dangerous for the arteries." This study, however, Rubba told Reuters Health, shows that obesity, particularly extra weight around the abdomen, is associated with blood vessel damage regardless of whether or not a person has high blood pressure. The study was done in women, but Rubba said the same "should also be true for men."

Rubba's team used ultrasound to measure the thickness of carotid arteries in 310 middle-aged women living in southern Italy. The researchers compared two measures of obesity--body mass index (BMI), which measures general obesity, and waist-to-hip ratio, which measures abdominal obesity--to the thickness of the carotid arteries.

Carotid artery thickness increased with obesity, Rubba and his colleagues report in the advance online edition of Stroke: Journal of the American Heart Association. Based on BMI, obese women had the thickest carotid arteries, followed by overweight women and then lean women. Similarly, women with the highest waist-to-hip ratios had the thickest carotid arteries.

Other risk factors for artery disease--such as high blood pressure and high cholesterol--often accompany obesity, but obesity was still directly related to artery thickness even after researchers accounted for these and other risk factors.

The study shows that "obesity should be treated in its own right for cardiovascular prevention," Rubba said. Treating high blood pressure alone, but not obesity, may be insufficient, he said.

In the report, Rubba and his colleagues point out that thickening of the carotid wall is an early sign of more widespread artery disease and can increase the risk of heart attack and other cardiovascular problems.

"It could be useful," they suggest, "to include carotid ultrasound assessment in screening evaluations of obese subjects to identify those at especially high cardiovascular risk who may require more aggressive therapy."

SOURCE: Stroke 2002;10.1161/01.STR.0000038989.90931.BE.


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