NEW YORK, Feb 28 (Reuters Health) -- Being overweight has been linked with
a whole host of problems, including diabetes, high cholesterol, and high blood
pressure. However, results of a study of elderly patients with high blood
pressure suggest that being very thin may also increase the risk of death and
stroke.
"The weight recommendations have been made for people regardless of age,
and I think what our study shows is that age is, in fact, an important factor,"
Dr. Sylvia Wassertheil-Smoller told Reuters Health. "Being too thin for elderly
hypertensives really can confer excess risk (of death and stroke)."
However, "you shouldn't go out and get fat," she cautioned. "The message
is that if you are older, with an average age of 71, you really do not have to
go bananas about trying to lose weight from the health point of view." She noted
that it is necessary to control risk factors such as high blood pressure and
cholesterol, and to stop smoking.
Wassertheil-Smoller, from the Albert Einstein College of Medicine of
Yeshiva University, Bronx, New York, and colleagues from the Systolic
Hypertension in the Elderly Program, studied 3,975 elderly patients aged 60 or
older with systolic hypertension who were being treated with either (an
inactive) placebo or antihypertensive therapy. Patients with systolic
hypertension have a high first number in their blood pressure reading, defined
as 160 or higher, and a normal second (diastolic) reading.
As reported in the February 28th issue of the Archives of Internal
Medicine, over the 5 years of the study, the investigators found that patients
with a low body mass index (BMI), a calculated ratio of weight to height, had an
increased risk of death and stroke compared with those in the midrange of BMI.
However, death and stroke rates were lower in patients receiving
antihypertensive drugs.
Why patients with lower BMIs have a greater risk of death is not clear.
"There may be an element of frailty in older people, and if they are of moderate
weight, they may withstand some physiological stresses better than people who
are frailer," Wassertheil-Smoller speculated. Another possibility is elderly
patients may have nutrient deficiencies essential to the immune system, she
said.
Although their study was specific for elderly hypertensive patients, she
said that other studies looking at excess weight and death have noted similar
results for low BMIs.
"In conclusion, elderly persons with systolic hypertension who are thin
should be especially carefully monitored for cardiovascular risk, nutritional
status, and other (illnesses), including depression, which is a risk factor for
death and may itself be related to poor nutritional status," the researchers
write.
