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Invited Commentary
February 2016

Obesity, Fitness, Hypertension, and Prognosis: Is Physical Activity the Common Denominator?

Author Affiliations
  • 1Department of Cardiology, Ochsner Medical Center, New Orleans, Louisiana
  • 2Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, New Orleans, Louisiana
  • 3Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana
  • 4The Office of Energetics, Nutrition Obesity Research Center, University of Alabama at Birmingham
JAMA Intern Med. 2016;176(2):217-218. doi:10.1001/jamainternmed.2015.7571

Obesity has many adverse effects on cardiovascular risk factors, such as dyslipidemia, metabolic syndrome or type 2 diabetes mellitus, and hypertension, as well as on cardiovascular structure and function. Therefore, it is not surprising that the prevalence of cardiovascular diseases is markedly increased in the setting of overweight and obesity.1 Considering that increased fat accumulation causes increases in total blood volume, stroke volume, and cardiac output, it is expected that obesity markedly increases the prevalence of hypertension and places a heavy strain on the left and right sides of the heart, which not surprisingly increases the prevalence of heart failure, even in a setting of metabolically healthy obesity.1

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1 Comment for this article
Key Insight
Stephen Albers | individual
This study has identified a key insight into the obesity epidemic: the reduction in leisure time since WWII. The primary culprit is Roosevelt's \"Rosie The Riveter\" which harnessed millions into sedentary jobs in the military industrial complex at the expense of leisure time.

Without discretionary time, families quickly lost the skills to feed themselves and became easy prey to the high calorie SOS junk food peddlers. This inevitably tipped the \"calories in minus calories out\" equation out of balance.

The only fast solution is a drastic reduction in food calorie density. The longer term solution is to
move away from the present 50 hour work week to the Western European model of 35 hours.