Obesity and Hypertension in Association with Diastolic Dysfunction Could Reduce Exercise Capacity

Kim, Jinshil; Kim, Myeong Gun; Kang, Sewon; Kim, Bong Roung; Baek, Min Young; Park, Yae Min; Shin, Mi Seung

doi:10.4070/kcj.2016.46.3.394

Cited by 18 publications

(12 citation statements)

References 26 publications

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“…When the direct and indirect effect occurred in opposite directions, the mediated % is reported to be 0. www.nature.com/scientificreports/ Similarly, to studies carried out in different socioeconomic contexts, we observed that early age at menarche is associated with higher diastolic blood pressure and triglycerides among young adult women 41 . Some studies have shown an intimate relationship between obesity/overweight, assessed by BMI, with diastolic function [42][43][44] , as well as the association between age at menarche and BMI-mediated diastolic blood pressure 23,45 . The use of more accurate measures of body composition to quantify the accumulation of body fat, contribute better to the prevention and intervention in cardiometabolic problems.…”

Section: Discussionmentioning

confidence: 99%

Early age at menarche and metabolic cardiovascular risk factors: mediation by body composition in adulthood

Bubach

Horta

Gonçalves

et al. 2021

Sci Rep

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Evidence suggests that early menarche increases cardiometabolic risk, and adiposity would be a possible mediator of this association. We assessed the association between age at menarche and metabolic cardiovascular risk factors and estimated the indirect effect of body composition in adulthood. In 1982, all hospital births in the city of Pelotas/Brazil, were identified and live births were examined and have been prospectively followed. At 30 years, information on age at menarche and metabolic cardiovascular risk factors was available for 1680 women. Mediation analysis was performed using G-computation to estimate the direct effect of age at menarche and the indirect effect of body composition. The prevalence of age at menarche < 12 years was 24.5% and was associated with higher mean diastolic blood pressure [β: 1.98; 95% CI: 0.56, 3.40], total cholesterol (β: 8.28; 95% CI: 2.67, 13.88), LDL-cholesterol (β: 6.53; 95% CI: 2.00, 11.07), triglycerides (β: 0.11; 95% CI: 0.03, 0.19). For diastolic blood pressure, total cholesterol, LDL-cholesterol, triglycerides, body composition assessed by fat mass index captured from 43.8 to 98.9% of the effect of early menarche, except to systolic blood pressure, HDL-cholesterol, C-reactive-protein. Suggesting that the effect of menarche age < 12 years on some metabolic cardiovascular risk factors is mediated partially by body composition in adulthood.

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Section: Discussionmentioning

confidence: 99%

Early age at menarche and metabolic cardiovascular risk factors: mediation by body composition in adulthood

Bubach

Horta

Gonçalves

et al. 2021

Sci Rep

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“…In our population, we also observed a significant association between definitely abnormal diastolic function (meeting three or more of the cutoff values of the 2016 guidelines) and all the parameters assessing the EC (Table 2). Declines in EC are related to numerous factors, including increasing age, being female, a high body mass index and several medical conditions such as diabetes and hypertension [[7], [8], [9]]. In our study, the multiple regression analysis revealed an independent association between these factors and EC, regardless of whether it was measured in terms of VO 2max , number of METS or cardiopulmonary exercise test duration (Table 3).…”

Section: Discussionmentioning

confidence: 49%

“…The association between diastolic dysfunction and VO 2max has also been confirmed in patients with dyspnoea [28] and heart valve disease [29]. Further, the diagnosis of diastolic dysfunction in individuals with cardiovascular risk factors and/or diabetes predicts the development of heart failure [5,9,30] and this may be of great clinical relevance regarding the need for aggressive management of this condition in such individuals.…”

Section: Discussionmentioning

confidence: 95%

“…Echocardiography is the tool most widely used in clinical practice for the diagnosis of LVDD and a document backed by European and American Societies has recently been published recommending cutoff values for diagnosing diastolic dysfunction [6]. On the other hand, it has been suggested that diastolic function abnormalities are associated with a reduction in exercise capacity (EC) in patients with no myocardial ischaemia [7] and that such an association can also be found in populations with diabetes, hypertension, and obesity [8,9]. The best method for assessing EC of an individual is a cardiopulmonary exercise test including direct measurement of maximal oxygen uptake [10].…”

Section: Introductionmentioning

confidence: 99%

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Diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesity

Alonso‐Gómez

Frau

Güemez

et al. 2019

IJC Heart & Vasculature

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BackgroundLeft ventricle diastolic dysfunction (LVDD) is a common finding in high risk individuals, its presence being associated with reduced exercise capacity (EC). We assessed the prevalence of LVDD, applying the 2016 guidelines of the American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI), in a population with overweight/obesity and metabolic syndrome and its association with EC.Methods and resultsThis was a prospective, cross-sectional study of a cohort of 235 patients (mean age of 65 ± 5 years old and 33% female) without heart disease and an ejection fraction >50% who underwent a complete echocardiographic assessment and cardiopulmonary exercise testing. Individuals meeting three or more criteria of the 2016 ASE/EACVI guidelines are considered to have LVDD, while tests are considered indeterminate in those meeting only two. Overall, 178 (76%) of our patients met one echocardiographic cutoff value for LVDD, 91 (39%) met two and 7 (3%) three or more. Patients meeting three cutoffs values showed a significant reduction in maximal oxygen uptake (16 ± 3 vs. 19.6 ± 5 ml/kg/min, p < .05), unlike those with indeterminate tests. In multiple regression analysis, meeting three cutoffs was associated with number of METS (ß = −2.2, p = .018). In exploratory analysis, using two criteria based on cutoffs different from those proposed in the guidelines, we identified groups with different EC.ConclusionsThe application of 2016 ASE/EACVI guidelines limited the prevalence of LVDD to 3%. This group showed a clear reduction of the EC. New echocardiographic cutoff values proposed in this study allow us to establish subgroups with different levels of EC.

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“…There have been contradicting opinions on the role of menopause in development of hypertension. Historically, age, increased BMI, and menopause have been suggested as significant risk factors for hypertension in peri-menopausal women [ 23 , 24 ]. Staessen et al emphasized menopause as an important contributor of hypertension even after adjusting for age and BMI [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome, not menopause, is a risk factor for hypertension in peri-menopausal women

Kang

Park

et al. 2018

Clin Hypertens

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BackgroundIt has been long debated whether menopause itself is a risk factor for hypertension in peri-menopausal women. We aimed to assess the association between menopause and hypertension, and whether metabolic syndrome (MetS) has an influence on its effect.MethodsData for 1502 women aged 42 to 53 from the Korean Genome and Epidemiology Study (KoGES) database were retrospectively analyzed. The KoGES database consists of 10,038 participants, of which 52.6% (5275) were female. Subjects were followed up for 4 years, and compared according to menopausal status. Additionally, 1216 non-hypertensive subjects were separately analyzed to assess whether a change in menopausal status was associated with development of hypertension.ResultsThe prevalence of hypertension, diabetes, and MetS for menopausal and non-menopausal subjects at baseline was 24.4% vs. 16.7%, 5.8% vs. 2.9%, and 25.4% vs. 16.6%, respectively (p < 0.01 for all comparisons). Among non-hypertensive subjects at baseline, prevalence of hypertension at 4-year follow-up was 9.4%, 19.7%, and 13.1% for non-menopausal, those who became menopause during follow-up, and those who were menopause at baseline, respectively. Development of hypertension was positively correlated with MetS (HR 3.90, 95% CI 2.51–6.07) and increased BMI (HR 1.09, 95% CI 1.03–1.16), while association with menopause was not significant.ConclusionsMenopause is closely associated with increased incidence of hypertension, but the increase may not be attributable to menopause itself but to increased prevalence of MetS.Electronic supplementary materialThe online version of this article (10.1186/s40885-018-0099-z) contains supplementary material, which is available to authorized users.

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Obesity and Hypertension in Association with Diastolic Dysfunction Could Reduce Exercise Capacity

Cited by 18 publications

References 26 publications

Early age at menarche and metabolic cardiovascular risk factors: mediation by body composition in adulthood

Early age at menarche and metabolic cardiovascular risk factors: mediation by body composition in adulthood

Diastolic dysfunction and exercise capacity in patients with metabolic syndrome and overweight/obesity

Metabolic syndrome, not menopause, is a risk factor for hypertension in peri-menopausal women

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