IMPROVEMENT OF MULTIPLE CORONARY RISK-FACTORS IN OBESE HYPERTENSIVES BY REDUCTION OF INTRAABDOMINAL VISCERAL FAT

The association of obesity and hypertension is well documented, and th e combination is important as a coronary risk factor, but its non-phar macological management is very difficult. Japanese hypertensive obese subjects (HO, n = 95) selected from 321 non-medicated obese subjects w ith a body mass index >25 kg/m2 were characterized by the clinical fea tures of significant diaphragmatic elevation, higher heart rate (HR), fasting blood glucose (FBS), total cholesterol (Tch), uric acid and ga mmaGTP values and lower vital capacity (VC) compared to those of normo tensive-obese subjects (NO, n = 226) (p < 0.01). During a diet therapy program (about 1,200 kcal/day) for HO (n = 55), 25 subjects were trea ted with a non-drug-dependent pulse-synchronized transpercutaneous ele ctric abdominal muscle stimulator (PEM) (ca. 30,000 muscle contraction s/day) for 4 weeks. These subjects showed significant improvement with reduction in body weight (9.4%, 7.4 kg), intra-abdominal visceral fat (VF) CT scan area (29%), abdominal subcutaneous area (10%) at the lev el of the umbilicus, blood pressure (BP), HR, FBS, gammaGTP, Tch, plas ma norepinephrine, plasma renin activity and plasma insulin, an increa se of VC and lowering of the diaphragm (p < 0.05). The reductions in w eight, BP, FBS and Tch in the diet group (n = 30, 1,200 kcal/day for 4 weeks) were smaller than those in the PEM-diet group (p < 0.05). The Japanese hypertensive obese patients had complications of many other c oronary risk factors, and the reduction in weight and VF with PEM-diet therapy seems to be effective for improving these risk factors.