Key result
Higher waist-to-height ratio was independently associated with elevated aortic blood pressure, systemic vascular resistance, and arterial stiffness, corresponding to the characteristics of primary hypertension.
Why the study?
Obesity-related hypertension and associated metabolic abnormalities are considered a distinct hypertensive phenotype, but how abdominal fat content influences blood pressure and hemodynamic profiles remained to be examined.
Does a higher waist:height ratio associate with elevated blood pressure and altered hemodynamic profiles in normotensive and never-treated hypertensive patients?
Cross-Sectional (n=541)
Does a higher waist:height ratio associate with elevated blood pressure and altered hemodynamic profiles in normotensive and never-treated hypertensive patients?
p-value: p=<0.05
Abdominal obesity is associated with elevated blood pressure, systemic vascular resistance, and arterial stiffness, suggesting its hemodynamic profile corresponds to primary hypertension rather than a distinct obesity-related phenotype.
Abdominal obesity may drive hypertension via vascular resistance and stiffness; leaves open phenotype-specific therapies pending prospective trials.
Background: Obesity-related hypertension and the associated metabolic abnormalities are considered as a distinct hypertensive phenotype. Here we examined how abdominal fat content, as judged by waist:height ratio, influenced blood pressure and hemodynamic profile in normotensive subjects and never-treated hypertensive patients. Methods: The 541 participants (20-72 years) underwent physical examination and laboratory analyses and were divided into age‑ and sex-adjusted quartiles of waist:height ratio. Supine hemodynamics were recorded using whole-body impedance cardiography, combined with analyses of radial tonometric pulse wave form and heart rate variability. Results: Mean waist:height ratios in the quartiles were 0.46, 0.51, 0.55 and 0.62. Radial and aortic blood pressure, systemic vascular resistance, pulse wave velocity, markers of glucose and lipid metabolism, leptin levels and C‑reactive protein were higher in quartile 4 when compared with quartiles 1 and 2 (p<0.05 for all). Cardiac index was lower in quartile 4 versus quartile 1, while no differences were seen in heart rate variability, augmentation index, plasma renin activity, and aldosterone concentration between the quartiles. Linear regression analyses showed independent associations of abdominal obesity with higher aortic systolic and diastolic blood pressure, systemic vascular resistance, and pulse wave velocity (p<0.05 for waist:height ratio in all regression models). Conclusions: Higher waist:height ratio was associated with elevated blood pressure, systemic vascular resistance, and arterial stiffness, but not with alterations in cardiac sympathovagal modulation or activation of the circulating renin-angiotensin-aldosterone system. Although obesity-related elevation of blood pressure has distinct phenotypic features, these results suggest that its main characteristics correspond those of primary hypertension. Trial registration: ClinicalTrails.gov NCT01742702 (date of registration 5 th December 2012)
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Taurio et al. (2022) conducted a cross-sectional in Abdominal obesity and hypertension (n=541). High waist-to-height ratio (abdominal obesity) vs. Lower waist-to-height ratio (Quartiles 1 and 2) was evaluated on Hemodynamic profile including radial and aortic blood pressure, systemic vascular resistance, and pulse wave velocity (p=<0.05). Higher waist-to-height ratio was independently associated with elevated aortic blood pressure, systemic vascular resistance, and arterial stiffness, corresponding to the characteristics of primary hypertension.
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