Cardiovascular receptors as drug targets. Eur omega Conferences' Cardiovascular receptors as drug targets. Institut Pasteur, Paris, France, 3-4 October 1996.
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The American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines makes every effort to avoid any actual, potential, or perceived conflict of interest that might arise as a result of an industry relationship or personal interest of the writing committee. Specifically, all members of the writing committee, as well as peer reviewers of the document, were asked to provide disclosure statements of all such relationships that might be perceived as real or potential conflicts of interest. These statements are reviewed by the parent task force, reported orally to all members of the writing committee at each meeting, and updated and reviewed by the writing committee as changes occur. Please see Appendix 1 for author relationships with industry and Appendix 2 for peer reviewer relationships with industry. These guidelines attempt to define practices that meet the needs of most patients in most circumstances. These guideline recommendations reflect a consensus of expert opinion after a thorough review of the available, current scientific evidence and are intended to improve patient care. If these guidelines are used as the basis for regulatory/payer decisions, the ultimate goal is quality of care and serving the patient's best interests. The ultimate judgment regarding care of a particular patient must be made by the healthcare provider and patient in light of all the circumstances presented by that patient.
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OBJECTIVE: To determine the extent and severity of obesity-related cardiorespiratory morbidity in children with body mass index (BMI) >or=40 kg/m(2). STUDY DESIGN: Cross-sectional analysis of a cohort comprised of 48 boys and girls aged 8 to 17 years with BMI >or=40 kg/m(2). Cardiorespiratory fitness (graded cycle exercise test), left ventricular (LV) mass (echocardiography), blood pressure, fasting lipid profile, fasting insulin, fasting glucose, HbA1c, and pulmonary function (spirometry and sleep studies) were measured. RESULTS: The cohort averaged 14.2 +/- 2 years of age with mean BMI of 45.5 kg/m(2). Only 2 patients had normal fitness; 37 of 48 had peak oxygen consumption <20 mL O(2)/minute. Hypertension was present in 10 of 48 patients. Mean lipid values were: triglycerides 103 +/- 48 mg/dL, HDL cholesterol 41 +/- 10 mg/dL, and LDL cholesterol 108 +/- 26 mg/dL. Type II diabetes mellitus was diagnosed in 6 patients. Mean fasting insulin was 31 +/- 19 microU/mL. Asthma treatment, small airways disease by pulmonary function testing, or both were present in 35 of 48 patients; upper airway obstruction was present in 7 patients. LV hypertrophy was present in 8 patients, with a mean LV mass of 43 +/- 11 g/m(2.7). CONCLUSIONS: Children and adolescents with BMI >or=40 kg/m(2) have substantial cardiorespiratory morbidity including severe physical deconditioning.
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