What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=61). Intervention: High visceral fat area (highest tertile) vs. Low visceral fat area (lowest tertile). Primary outcome: Standard deviation (SD) of home systolic blood pressure (Coefficient of regression -3.28, 95% CI -5.60 to -0.97, p=0.008).

What does this research mean for the field?

Higher visceral fat area is significantly associated with lower day-to-day variability in home systolic blood pressure among adult hypertensive patients. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 5, 2018Open Access

Cross-sectional study of the association between day-to-day home blood pressure variability and visceral fat area measured using the dual impedance method

JKJunko KuwabaraKyoto University KKKoichiro KuwaharaHeart Failure & Transplant YKYoshihiro KuwabaraOsaka International Cancer Institute

Key Result

Higher visceral fat area was significantly associated with lower day-to-day variability in home systolic blood pressure (adjusted coefficient of regression -3.28) in adult hypertensive patients.

Study Design

Type

Cross-Sectional (n=61)

Multicenter

Structured PICO

Is visceral fat area associated with day-to-day home blood pressure variability in adult hypertensive patients?

Population

61 adult hypertensive patients (aged ≥20 years), mean age 64.3, 67.2% male, from a single center in Kyoto, Japan. Inclusion: office BP ≥140/90 mmHg, home BP ≥135/85 mmHg, or receiving anti-hypertensive treatment.

Outcome

Standard deviation (SD) and coefficient of variance (CV) of home systolic blood pressure (SBP) over 7 consecutive dayssurrogate

Visceral fat area is negatively correlated with day-to-day home blood pressure variability in hypertensive patients, suggesting the degree of obesity should be considered when evaluating BP variability.

Main Result

Effect estimate: Coefficient of regression -3.28 (95% CI -5.60 to -0.97)

Absolute Event Rate: 5.84% vs 8.4%

p-value: p=0.008

Limitations

Could not fully correct for factors influencing home BP variability such as medication adherence and lifestyle factors
Cross-sectional design cannot evaluate causal relationships
Relatively small sample size

Abstract

BACKGROUND: The blood pressure (BP) variability (BPV) is a predictor of cardiovascular disease, independently of the BP itself. In addition, visceral fat accumulation can trigger atherosclerotic disease through various mechanisms. METHODS AND RESULTS: We examined the association between fat accumulation and day-to-day BPV in 61 adult hypertensive patients. Visceral fat area (VFA) was measured using the dual bioelectrical impedance analysis method. Participants were divided into three groups based on VFA. The standard deviation (SD) in home systolic BP (SBP) for 7 consecutive days was significantly lower in the high VFA tertile (low VFA, 8.40±4.15 mmHg; intermediate VFA, 8.47±2.80 mmHg; and high VFA, 5.84±2.37 mmHg, p of One-way ANOVA = 0.017, p for trend = 0.0126). A similar association was observed between the coefficient of variance (CV) of home SBP and the VFA tertile. Multiple-regression analysis adjusted for age, sex, antihypertensive drug, diabetes, habitual drinking, and SBP level also showed a significant association between the VFA tertile and the SD or CV of home SBP. The adjusted coefficient of regression for the SD of home SBP was -3.28 (95%CI: -5.60 to -0.97, p = 0.008) and the CV of home SBP was -2.51 (95%CI: -4.31 to -0.71, p = 0.008) for the highest VFA tertile as compared to the lowest VFA tertile. CONCLUSIONS: These results show for the first time negative correlation between VFA and day-to-day BPV. The degree of obesity should be taken into account when evaluating the value of BPV.

AI에게 질문

Bookmark

View Full Paper