Obesity in young hypertensive subjects was associated with decreased 24-hour epinephrine output (2.0 mcg/g vs 2.5 mcg/g in normal weight; p=0.0069), independent of metabolic status.
Cohort (n=640)
Does 24h epinephrine output differ across BMI groups in young untreated hypertensives, and does it predict metabolic changes?
Adrenergic tone, measured by 24h epinephrine output, is decreased in young obese hypertensive individuals independent of metabolic status, and this lower tone attenuates future glucose increases.
Tasa de eventos absoluta: 2% vs 2.5%
valor p: p=0.0069
Objective: The main goal of the present study was to test whether differences in 24 h epinephrine output (24hEpi) might discriminate between obese hypertension and lean hypertension in young subjects and whether metabolic abnormalities may influence the relationship between increased BMI and 24hEpi. Design and method: We studied 640 young-to-middle-age stage I untreated hypertensives. Mean age was 33.1±8.6 years and blood pressure (BP) was 145.5±10.6/93.5±5.7 mmHg. Participants were classified into three BMI groups according to whether they had normal weight (NW), overweight (Ow) or obesity (Ob). In addition, they were classified according to the number of metabolic abnormalities from 0 to 4. During 24 h ambulatory BP monitoring, urine was collected for 24hEpi measurement. 24hEpi was measured by high-performance liquid chromatography and normalized by 24-hour creatinine output. After a median follow-up of 6.02 years, body weight and metabolic variables were remeasured. The effect of BMI group and metabolic abnormalities on 24hEpi (log-converted) was tested cross-sectionally in a two-way ANCOVA adjusting for age and sex. The longitudinal effects of 24hEpi were tested with ANCOVA and multiple regressions also adjusting for baseline values. Results: A significant inverse correlation was found between BMI and log24hEpi (p0.22). During the 6-year follow-up, body weight increased by 2.4±7.2 Kg (p<0.001) and serum glucose by 1.2±12.8 mg/dL (p=0.025). Baseline 24hEpi was not predictive of body weight changes from baseline to study end (p=0.34) but predicted the increase in serum glucose (p=0.0034) with a significant interaction between BMI group and 24hEpi (p=0.022) on glucose change. Conclusions: Adrenergic tone is decreased in young obese hypertensive individuals, an effect independent of metabolic status. Our study cannot establish whether this feature is the cause or consequence of obesity. However, low 24hEpi in obese subjects attenuates the increase in glucose associated with high BMI.
Palatini et al. (Fri,) conducted a cohort in Stage I untreated hypertension (n=640). Obesity (high BMI) vs. Normal weight was evaluated on 24 h epinephrine output (Log24hEpi) (p=0.0069). Obesity in young hypertensive subjects was associated with decreased 24-hour epinephrine output (2.0 mcg/g vs 2.5 mcg/g in normal weight; p=0.0069), independent of metabolic status.