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Obesity, Hypertension, and Cardiovascular Disease-Reply

Ellen Bloom, MD, MPH; Katsuhiko Yano, MD
JAMA. 1987;257(12):1598. doi:10.1001/jama.1987.03390120060012.
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In Reply.—  Dr Messerli's comments in his Letter to the Editor appear to contradict his own previously published statements. Here is a representative sample of quotations from his articles on obesity and hypertension:"Hypertension and obesity are two disorders that have been closely related, each occurring in greater frequency with the other than in an otherwise normal population. Although a causal relationship has not been established between the two, their coincidence carries increased risk of cardiovascular morbidity and mortality."1"The combination of obesity and hypertension burdens the heart with high preload and high afterload, thereby greatly enhancing the risk of congestive heart failure.... Obesity hypertension may be the result of an inappropriately raised cardiac output in the presence of a relatively restricted arterial capacity due to the low vascularity of adipose tissue."2"Since both obesity and hypertension increase cardiac workload, although by different mechanisms, their presence in the


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