The influence of body composition and fat distribution on circadian blood pressure rhythm and nocturnal mean arterial pressure dipping in patients with obesity.
Marek TałałajAgata Bogołowska-StieblichMichał WąsowskiAda SawickaPiotr JankowskiPublished in: PloS one (2023)
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.
Keyphrases
- body composition
- blood pressure
- hypertensive patients
- body mass index
- weight gain
- bone mineral density
- resistance training
- dual energy
- heart rate
- adipose tissue
- end stage renal disease
- newly diagnosed
- metabolic syndrome
- insulin resistance
- obstructive sleep apnea
- body weight
- postmenopausal women
- type diabetes
- chronic kidney disease
- risk factors
- physical activity
- coronary artery disease
- magnetic resonance imaging
- sleep quality
- high fat diet induced
- patient reported
- peritoneal dialysis
- mass spectrometry
- cardiovascular disease
- prognostic factors
- atrial fibrillation
- cardiovascular events
- high density
- depressive symptoms
- magnetic resonance
- high intensity