Effect of Obesity on Blood Pressure and Arterial Stiffness in Middle-Aged Korean Women

Son, Won-Mok; Kim, Do-Yeon; YouSin, Kim; Ha, Min‐Seong

doi:10.24171/j.phrp.2017.8.6.02

Cited by 14 publications

(11 citation statements)

References 13 publications

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“…Interestingly, it was observed that in the more obese group, the diastolic pressure increases more ( p < 0.001) than systolic pressure as compared to the less obese group (e.g., mean 24-h systolic pressure was higher in group 2 by 5 mmHg as compared to group 1, and diastolic pressure by as much as 9 mmHg). A similar association, additionally correlated with increased vessel stiffness in such patients, was reported by Korean authors, though their patient group was rather small [ 18 ]. Unlike in our study, according to the paper by Higgins et al of 1988, based on the Framingham study, greater body weight was associated with increased systolic and diastolic pressure proportionally to baseline—patients with the upper quintile values of BMI demonstrated higher systolic pressure by 16 mmHg and higher diastolic pressure by 9 mmHg as compared to patients with the lowest quintile values of BMI [ 19 ].…”

Section: Discussionsupporting

confidence: 80%

The Impact of Obesity on Nighttime Blood Pressure Dipping

et al. 2020

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Background and objectives: It is commonly known that obesity not only increases arterial hypertension (HT) risk but also impacts on the response to antihypertensives. This study aimed to assess blood pressure (BP) parameters based on Ambulatory Blood Pressure Measurement (ABPM) in obese patients. Materials and Methods: The study group consisted of 128 patients with obesity (BMI ≥ 30 kg/m2), with an average age of 43.25 years (±12.42), including 55 males and 73 females. They were divided into 2 groups: 1-with BMI ≥ 30 kg/m2 and <40 kg/m2, 2-with BMI ≥ 40 kg/m2. Each patient underwent 24-h blood pressure monitoring. The average 24-h, daytime and nighttime systolic and diastolic pressure, as well as 24-h mean heart rate and % of nocturnal dip, were assessed. Results: Mean BMI in group 1 was 34.73 kg/m2 (±2.96), and in group 2 it was 47.6 kg/m2 (±6.3). Group 1 was significantly older than group 2 (46.5 vs. 39 years old). The analysis of ABPM revealed significantly higher BP values in all measurements in group 2 (i.e., systolic blood pressure (SBP) 24 h median = 132 mmHg; diastolic blood pressure (DBP) 24 h median = 84 mmHg). The nocturnal dip was greater in group 1 (8.95%). Mean 24-h heart rate was also higher in group 2 (median = 76 beats/min) than group 1 (median = 67.5 beats/min). More than half of patients in group 2 had been previously treated for HT, and based on ABPM, new HT was diagnosed in 6 patients from group 1 and 14 patients from group 2. Three groups of patients were identified based on nighttime dip: dipper, non-dipper, and reverse-dipper. No patient of the extreme dipper type was found. Group 2 comprised of significantly more patients of the reverse-dipper type. Conclusions: Patients with extreme morbid obesity frequently exhibit HT of the reverse-dipping pattern. This type is often linked with a higher risk of more advanced cardiovascular illness.

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Section: Discussionsupporting

confidence: 80%

The Impact of Obesity on Nighttime Blood Pressure Dipping

et al. 2020

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“…In our study, the obese show an increase in SBP, DBP and MAP with a return to baseline values at the end of surgery. These results are in accordance with those of preceding studies, which demonstrate that obesity is closely related to blood pressure [19].…”

Section: Discussionsupporting

confidence: 94%

The Feasibility and Applications of Non-invasive Cardiac Monitoring in Obese Patients Undergoing Day-case Surgery: Results of a Prospective Observational Study

Sansone¹,

Giaccari²,

Colella³

et al. 2020

TOATJ

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Aims: This prospective observational study evaluates the utility of non-invasive cardiac monitoring in obese patients in the day-surgery case, considering factors, such as Body Mass Index (BMI) and anaesthesia technique. Background: Obese patients are more likely to be admitted to hospital or to get hospitalized because they are more prone to concomitant diseases and obesity itself is not a contraindication to day surgery. Obese patients are a high-risk patient population that may particularly benefit from monitoring perioperative haemodynamic variations. Methods: In this observational study, we compared haemodynamic variations between overweight or obese and normal weight patients undergoing day-case surgery. We adopted NICOM® as a non-invasive cardiac output monitoring. Objective: The aim of the current study was to investigate the haemodynamic impact of BMI and anaesthesia technique during day-case surgery procedures. The other goal was to evaluate the feasibility and applications of non-invasive cardiac output monitoring among the obese population in day-surgery. Results: 74 patients were included in the study. 34 were overweight or obese (weight 84 ± 10 kg, height 160 ± 10 cm, BMI ≈ 30 kg/m2), 40 were normal weight (weight 63 ± 15 kg, height 160 ± 10 cm, BMI ≈ 22 kg/m2). Compared to normal-weight patients, obese patients show an increase in blood pressure with a return to baseline values at the end of surgery (p < 0.05). The Cardiac Output (CO) shows a similar trend, whereas the heart rate is normal. A decrease in the Cardiac Index (CI) during the operation was noticed in both groups, the one in obese patients (p = 0.24) being greater. In the same way, the Stroke Volume Index (SVI) was lower in obese patients during surgery (p < 0.05). In spinal anaesthesia, the Total Peripheral Resistance Index (TPRI) was not statistically different between the groups of study. As for the TPRI in obese patients, we reported values similar to the ones in non-obese patients in spinal anaesthesia. In local anesthesia, TPRI was higher in obese patients than in non-obese. Conclusion: Cardiovascular alterations in relation to obesity include an increase in blood pressure, CO and SV. An inadequate monitoring of haemodynamic parameters is a risk factor for perioperative complications. NICOM® provides a continuous, non-invasive haemodynamic measurement.

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“…24 Numerous studies have examined associations between individual components of LS7 and arterial stiffness. They have reported significant and generally consistent positive associations between central arterial stiffness and diabetes and prediabetes, 25,26 obesity, 27,28 physical inactivity, 6,29,30 high BP, 31 total cholesterol, 32 and dyslipidemia. 33 The relation between smoking and arterial stiffness might be dependent on the anatomic segment of the vascular tree assessed.…”

Section: Discussionmentioning

confidence: 93%

Greater Adherence to Life’s Simple 7 Is Associated With Less Arterial Stiffness: the Atherosclerosis Risk in Communities (ARIC) Study

Oyenuga

Folsom

Cheng

et al. 2019

American Journal of Hypertension

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Background Greater arterial stiffness is associated independently with increased cardiovascular disease risk. The American Heart Association (AHA) has recommended following “Life’s Simple 7 (LS7)” to optimize cardiovascular health; we tested whether better LS7 in middle age is associated with less arterial stiffness in later life. Methods We studied 4,232 black and white participants aged 45–64 years at the baseline (1987–89) visit of the Atherosclerosis Risk in Communities Study cohort who also had arterial stiffness measured in 2011–13 (mean ± SD interval: 23.6 ± 1.0 years). We calculated a 14-point summary score for baseline LS7 and classified participants as having “poor” (0–4), “average” (5–9), or “ideal” (10–14) cardiovascular health. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (95% CI) for arterial stiffening: a high carotid-femoral pulse wave velocity (cfPWV, ≥13.23 m/s) or a high central pulse pressure (central PP, ≥ 82.35 mm Hg). Results The age, race, sex, and heart rate-adjusted ORs (95% CI) for high cfPWV in the “ideal,” “average,” and “poor” LS7 summary categories were 1 (Reference), 1.30 (1.11, 1.53), and 1.68 (1.10,2.56), respectively (P-trend = 0.0003). Similarly, the adjusted ORs (95% CI) for high central PP across LS7 summary categories were 1 (Reference), 1.48 (1.27, 1.74), and 1.63 (1.04, 2.56), respectively (P-trend <0.0001). Conclusion Greater LS7 score in middle age is associated with less arterial stiffness 2–3 decades later. These findings further support the AHA recommendation to follow LS7 for cardiovascular disease prevention.

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Effect of Obesity on Blood Pressure and Arterial Stiffness in Middle-Aged Korean Women

Cited by 14 publications

References 13 publications

The Impact of Obesity on Nighttime Blood Pressure Dipping

The Impact of Obesity on Nighttime Blood Pressure Dipping

The Feasibility and Applications of Non-invasive Cardiac Monitoring in Obese Patients Undergoing Day-case Surgery: Results of a Prospective Observational Study

Greater Adherence to Life’s Simple 7 Is Associated With Less Arterial Stiffness: the Atherosclerosis Risk in Communities (ARIC) Study

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