Scientific weight loss: effectively reduces the risk of obesity, high blood pressure, and coronary heart disease.

Treatment of Obese Hypertension: The mortality rate of obese individuals with hypertension is generally lower than that of non-obese hypertensive patients. Management of hypertension in obese individuals primarily involves restricting calorie and sodium intake to achieve weight loss and lower blood pressure. Physical exercise can improve work capacity and enhance cardiac function; even without calorie restriction, exercise itself can lower blood pressure, especially in patients with hyperinsulinemia, where exercise can significantly reduce insulin levels, blood glucose, and triglyceride concentrations, leading to a significant drop in blood pressure. Furthermore, exercise can inhibit sympathetic nerve activity and lower plasma catecholamine levels, thereby reducing blood pressure and peripheral vascular resistance. Even if dietary control and increased physical activity are ineffective for obese individuals with elevated blood pressure, it is still necessary to use antihypertensive medications and monitor for other causes of secondary hypertension, providing appropriate treatment.

Risk factors for coronary heart disease include variable and invariable factors. Invariable factors include age, sex, and genetic background. Variable factors include obesity, hyperlipidemia, insulin resistance, diabetes, smoking, dietary sodium intake, and a sedentary lifestyle. Obesity is not only an independent risk factor for coronary heart disease (CHD) but also a major cause of other risk factors (such as hypertension, hyperlipidemia, and diabetes).

Mechanisms by which obesity causes CHD:

1. Direct effects of obesity on the heart: Obese patients have increased basal metabolism and cardiac output. This increase is not achieved by increasing heart rate but by increasing stroke volume; high cardiac output can lead to eccentric hypertrophy of the left ventricle and diastolic dysfunction. Increased blood volume in obese patients, if peripheral resistance remains constant, will lead to elevated blood pressure and excessive pressure load on the left ventricle, resulting in concentric hypertrophy of the left ventricle. The combined effect of obesity and hypertension has a greater impact on the structure and function of the left ventricle.

Furthermore, obese individuals have increased oxygen consumption due to increased cardiac output. During exercise, the oxygen consumption of obese individuals is twice that of those of normal weight, thus obese individuals are prone to exertional angina.

2. Obesity causes hyperlipidemia: Obese patients often also have hyperlipidemia. Elevated low-density lipoprotein (LDL-C) levels are positively correlated with the occurrence of coronary heart disease (CHD), while elevated high-density lipoprotein (HDL-C) levels are negatively correlated. Furthermore, an elevated TC/HDL-C ratio is an effective indicator of atherosclerotic risk.

3. Obesity Causes Hypertension
Studies have shown that elevated blood pressure is an independent risk factor for CHD. The incidence of CHD in hypertensive patients is five times higher than in those with normal blood pressure, and the higher the blood pressure and the longer the duration of hypertension, the greater the risk of CHD. Currently, most scholars believe that hypertension, like elevated serum cholesterol, has a causal relationship with CHD.

4. Obesity Causes Diabetes
The incidence of CHD, myocardial infarction, and mortality in diabetic patients is far higher than in non-diabetic individuals, and the age of onset is earlier. At the time of onset, 50% of type 2 diabetic patients already have hypertension, and 30% already have CHD; they also already have insulin resistance and hyperinsulinemia. Insulin acts directly on blood vessels, increasing their responsiveness to catecholamines and angiotensin II, and also promotes smooth muscle cell growth, thereby contributing to atherosclerosis. Changes in the structure of the blood vessel wall and the diameter of the vessels increase vascular reactivity and lead to hypertension. Therefore, diabetes is also one of the main risk factors for atherosclerosis. Furthermore, obese individuals have reduced physical activity, making it difficult for collateral circulation to form after plaques form in the coronary arteries.