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Joint scientific statement of the European Association for the Study of Obesity and the European Society of Hypertension: obesity and early vascular ageing

Jordan, Jensa; Nilsson, Peter M.b; Kotsis, Vasiliosc; Olsen, Michael H.d,e; Grassi, Guidof; Yumuk, Volkang; Hauner, Hansh; Zahorska-Markiewicz, Barbarai; Toplak, Hermannj; Engeli, Stefana; Finer, Nickk

doi: 10.1097/HJH.0000000000000473

Current cardiovascular risk scores do not include obesity or fat distribution as independent factors, and may underestimate risk in obese individuals. Assessment of early vascular ageing (EVA) biomarkers including arterial stiffness, central blood pressure, carotid intima–media thickness and flow-mediated vasodilation may help to refine risk assessment in obese individuals in whom traditional cardiovascular risk scores and factors suggest no need for specific medical attention. A number of issues need to be addressed before this approach is ready for translation into routine clinical practice. Methodologies for measurements of vascular markers need to be further standardized and less operator-dependent. The utility of these nontraditional risk factors will also need to be proven in sufficiently large and properly designed interventional studies. Indeed, published studies on vascular markers in obesity and weight loss vary in quality and study design, are sometimes conducted in small populations, use a variety of differing methodologies and study differing vascular beds. Finally, current vascular measurements are still crude and may not be sufficient to cover the different aspects of EVA in obesity.

aInstitute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany

bDepartment of Clinical Sciences, Lund University, University Hospital, Malmö, Sweden

cHypertension-24 h ABPM ESH Center of Excellence, Papageorgiou Hospital, Aristotle University Thessaloniki, Thessaloniki, Greece

dThe Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Center for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark

eHypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences, North-West University, Mahikeng, South Africa

fClinica Medica, Università Milano-Bicocca, and Istituto di Ricerche a Carattere Scientifico IRCCS Multimedica, Sesto san Giovanni, Milan, Italy

gDivision of Endocrinology, Metabolism and Diabetes, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

hElse Kröner-Fresenius Center for Nutritional Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany

iObesity Management Clinic ‘WAGA’, Katowice, Poland

jUniversity Clinic of Internal Medicine, Medical University Graz, Graz, Austria

kNational Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science, University College London, London, UK

Correspondence to Jens Jordan, Institute of Clinical Pharmacology, Working Group on Hypertension in Obesity, Diabetes, and High Risk Patients of the European Society of Hypertension, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany. Tel: +49 511 532 2820; fax: +49 511 532 2750; e-mail:

Abbreviations: EASO, European Association for the Study of Obesity; ESH, European Society of Hypertension; EVA, early vascular ageing

Received 10 October, 2014

Revised 29 October, 2014

Accepted 29 October, 2014

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