Blood pressure and its circadian pattern in obese and lean premenopausal women
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Abstract
Background. Obesity is frequently referred to as an independent risk factor for high blood pressure and hypertension is very prevalent among obese people. The aims of this study were: to compare office-based and 24 h blood pressure (BP) and its circadian pattern between lean and obese women; to study correlations between BP, insulin resistance (IR) and markers of subclinical inflammation/early atherosclerosis.
Material and methods. Eighty-eight lean and 107 otherwise healthy obese women were characterized for anthropometrics, BP (office-based determinations and 24 h ABPM) and for glucose, insulin, triglycerides, inteleukin 6 (IL-6), tumor necrosis factor alpha (TNF-a), high-sensitivity C reactive protein (hs-CRP), retinol-binding protein 4 (RBP-4), leptin, adiponectin, resistin, monocyte chemoattractant protein 1 (MCP-1), intercellular adhesion molecule 1 (ICAM-1), and vascular-cellular adhesion molecule 1 (VCAM-1). Insulin resistance was determined by homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and McAuley indexes (also Matsuda in obese).
Results. Obese group presented higher office-based systolic/diastolic BP, systolic ambulatory blood pressure monitoring (ABPM), and more non-dippers. HOMA-IR and body fat was correlated to systolic (r2 = 0.176) and glucose to diastolic (p = 0.008; r = 0.256) ABPM. Age, QUICKI, and TNF-a was correlated with dipping (r2 = 0.172); adiponectin, age, BMI, and glucose to systolic (r2 = 0.226) and diastolic (r2 = 0.215) office-based BP. Concerning lean women, MCP-1 was associated with diastolic ABPM (p = 0.013; r = 0.267). Systolic office-based BP was associated with waist-to-hip ratio (p = 0.01; r = 0.273); this and RBP-4 was correlated with office-based diastolic BP (r2 = 0.12).
Conclusion. Although relatively healthy, obese women present higher BP than lean. Anthropometrics, IR, and fasting glucose all influence BP in obesity; additionally, IR is involved in non-dipping. No strong correlation exists between BP/dipping and subclinical inflammation in either group of women.
Keywords: obesityhypertensioncardiovascular diseasesdippingsubclinical inflammation
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