Lack of abnormal rise in blood pressure in obese subjects is associated with less structural and functional cardiovascular abnormalities

Background Abdominal adiposity has been reported to be associated with an abnormally elevated rise in blood pressure after exercise. Adults with both excess abdominal adiposity and an abnormal rise in blood pressure have been reported to be at higher risk for cardiovascular disease. However, some subjects may be metabolically healthy despite obesity. The purpose of this study is to see whether adults with obesity who exhibit a normal rise in blood pressure display any cardiovascular structural and functional abnormalities observed in obese adults with an abnormal rise in blood pressure. Methods We screened 244 obese subjects for cardiovascular disease risk assessment utilizing the ASCVD risk assessment score, previously published. The ASCVD assessment includes 10 tests, 3 of which are cardiac, and 7 of which are vascular. Additional testing included CT scan for coronary artery calcium score and epicardial fat volume utilizing Siemens Somatom Definition 64. The 244 subjects were divided into 2 groups: those with normal (122 subjects) and those with an abnormal rise in blood pressure (122 subjects) as defined as a blood pressure rise of >30 mmHg post-exercise. Results are shown in Table 1. Due to the prominent effect of age on CVD risk factors, subjects were further stratified into age <60 and age ≥60 categories (98 and 25 subjects, respectively). Results are shown in Table 2. Results 1. As shown in Table 1:. a) Obese adults with normal rise in blood pressure are found to have a lower prevalence of impaired small artery elasticity (C2), elevated systolic blood pressure, and elevated CRP. b) Obese adults with abnormal rise in blood pressure may exhibit higher vascular risks regarding C2, systolic blood pressure, and CRP levels, but otherwise are not significantly different from obese subjects with normal blood pressure rise with regards to cardiovascular risk. 2. As shown in Table 2, older subjects are at greater risk of having impaired small artery elasticity and elevated CRP. Conclusions Obesity is a major cardiovascular risk factor, specifically when defined as elevated waist circumference. When combined with elevated blood pressure rise post-exercise and or aging, obesity may result in significant cardiovascular complications. We recommend intervention with weight management strategies. Early detect to protect!