Key result
Higher body mass index was associated with a significantly increased prevalence of non-dipping nocturnal blood pressure, rising from 38.2% in patients with BMI <40 to 83.3% in those with BMI ≥55 (p=0.002).
Why the study?
Loss of physiological nocturnal blood pressure decline independently predicts cardiovascular risk and mortality, but the influence of body composition and fat distribution on 24-hour patterns remains unclear.
Cross-Sectional (n=436)
Absolute Event Rate: 83.3% vs 38.2%
p-value: p=0.002
In patients with obesity, increasing BMI, lean body mass, and abdominal fat distribution are significantly associated with a loss of physiological nocturnal blood pressure dipping.
Should not yet change BP management in obesity; leaves open whether body composition causally drives non-dipping in prospective studies.
Loss of physiological nocturnal blood pressure (BP) decline is an independent predictor of cardiovascular risk and mortality. The aim of the study was to investigate the influence of body composition and fat distribution on 24-hour BP pattern and nocturnal dipping of mean arterial pressure (MAP) in patients with obesity. The study comprised 436 patients, 18 to 65 years old (306 women), with BMI ≥30 kg/m2. Body composition was assessed with dual-energy X-ray absorptiometry (DXA) and blood pressure was assessed by 24-hour BP monitoring. The prevalence of hypertension was 64.5% in patients with BMI <40 kg/m2 and increased to 78.7% in individuals with BMI ≥50 kg/m2 (p = 0.034). The whole-body DXA scans showed that the hypertensive patients were characterized by a greater lean body mass (LBM) and a higher abdominal-fat-to-total-fat-mass ratio (AbdF/FM), while the normotensive participants had greater fat mass, higher body fat percentage and more peripheral fat. Loss of physiological nocturnal MAP decline was diagnosed in 50.2% of the patients. The percentage of non-dippers increased significantly: from 38.2% in patients with BMI <40 kg/m2 to 50.3% in those with BMI 40.0-44.9 kg/m2, 59.0% in patients with BMI 45.0-49.9 kg/m2, 71.4% in those with BMI 50.0-54.9 kg/m2 and 83.3% in patients with BMI ≥55 kg/m2 (p = 0.032, p = 0.003, p<0.001, and p = 0.002 vs. BMI <40 kg/m2, respectively). The multivariable regression analysis showed that patients at the highest quartiles of body weight, BMI, LBM and AbdF/FM had significantly reduced nocturnal MAP dipping compared with patients at the lowest quartiles, respectively.
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Tałałaj et al. (2023) conducted a cross-sectional in Obesity (n=436). Higher body mass index (≥55 kg/m2) vs. Lower body mass index (<40 kg/m2) was evaluated on Loss of physiological nocturnal MAP decline (non-dipping) (p=0.002). Higher body mass index was associated with a significantly increased prevalence of non-dipping nocturnal blood pressure, rising from 38.2% in patients with BMI <40 to 83.3% in those with BMI ≥55 (p=0.002).
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