Obesity Increases Blood Pressure Variability during the Night
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Previous studies have reported that obesity increases heart rate variability. Body mass index (BMI) has beenreported to affect blood pressure variability (BPV) over 24 hours. However, the diurnal variation in the effect of BMI onBPV has not been evaluated. This study aimed to clarify the diurnal variation in the effect of BMI on BPV. Methods: A totalof 2,044 patients were consecutively enrolled in this study, and the data were analyzed retrospectively. All patientsunderwent 24-hour ambulatory blood pressure monitoring. We divided patients into two groups according to BMI(non-obese group: n = 1,145, BMI < 25; obese group: n = 899, BMI ≥ 25). We compared BPV during daytime and nighttimebetween the non-obese and obese groups. We also evaluated the impact of BMI on BPV by multivariate regression analysis. Results: On univariate regression analysis, there was no significant difference in BPV during daytime (systolic BP [SBP]variability: 20.7 vs. 21.7, p = 0.511; diastolic BP [DBP] variability: 16.8 vs. 17.5, p = 0.539). However, both SBP variability(13.8 vs. 17.6, p = 0.009) and DBP variability (11.7 vs. 14.3, p = 0.042) during nighttime were affected significantly byBMI. After adjusting other compounding variables (age > 60 years, current smoking habit, hypertension, diabetes mellitus,and use of calcium channel blockers and renin-angiotensin-aldosterone system blockers), multivariate analysis showed thatBMI was an independent factor associated with increase in BPV during the night (SBP variability: p = 0.039; DBPvariability: p = 0.034). Conclusions: Obesity increased BPV during nighttime.
Abstract
Background: Previous studies have reported that obesity increases heart rate variability. Body mass index (BMI) has beenreported to affect blood pressure variability (BPV) over 24 hours. However, the diurnal variation in the effect of BMI onBPV has not been evaluated. This study aimed to clarify the diurnal variation in the effect of BMI on BPV. Methods: A totalof 2,044 patients were consecutively enrolled in this study, and the data were analyzed retrospectively. All patientsunderwent 24-hour ambulatory blood pressure monitoring. We divided patients into two groups according to BMI(non-obese group: n = 1,145, BMI < 25; obese group: n = 899, BMI ≥ 25). We compared BPV during daytime and nighttimebetween the non-obese and obese groups. We also evaluated the impact of BMI on BPV by multivariate regression analysis. Results: On univariate regression analysis, there was no significant difference in BPV during daytime (systolic BP [SBP]variability: 20.7 vs. 21.7, p = 0.511; diastolic BP [DBP] variability: 16.8 vs. 17.5, p = 0.539). However, both SBP variability(13.8 vs. 17.6, p = 0.009) and DBP variability (11.7 vs. 14.3, p = 0.042) during nighttime were affected significantly byBMI. After adjusting other compounding variables (age > 60 years, current smoking habit, hypertension, diabetes mellitus,and use of calcium channel blockers and renin-angiotensin-aldosterone system blockers), multivariate analysis showed thatBMI was an independent factor associated with increase in BPV during the night (SBP variability: p = 0.039; DBPvariability: p = 0.034). Conclusions: Obesity increased BPV during nighttime.
참고문헌 (25)
- Kannel WB., "Blood pressure as a cardiovascular risk factor : prevention and treatment", JAMA, 275, pp.1571~1576 (1996)
- Eckel RH, "Prevention Conference VII : obesity, a worldwide epidemic related to heart disease and stroke : executive summary", Circulation, 110, pp.2968~2975 (2004)
- Obesity: preventing and managing the global epidemic, "World Health Organization", World Health Organization, ~, pp.WHO technical report series no. 894 (2000)
- Hansen TW, "Prognostic value of reading-to-reading blood pressure variability over 24 hours in 8938 subjects from 11 populations", Hypertension, 55, pp.1049~1057 (2010)
- Eto M, "Impact of blood pressure variability on cardiovascular events in elderly patients with hypertension", Hypertens Res, 28, pp.1~7 (2005)
- Eguchi K, "Night time blood pressure variability is a strong predictor for cardiovascular events in patients with type 2 diabetes", Am J Hypertens, 22, pp.46~51 (2009)
- Shan ZZ, "Arterial baroreflex deficit induced organ damage in sinoaortic denervated rats", J Cardiovasc Pharmacol, 38, pp.427~437 (2001)
- Drayer JI, "Circadian blood pressure patterns in ambulatory hypertensive patients : effects of age", Am J Med, 73, pp.493~499 (1982)
- Tatasciore A, "Awake blood pressure variability, inflammatory markers and target organ damage in newly diagnosed hypertension", Hypertens Res, 31, pp.2137~2146 (2008)
- Hata Y, "Office blood pressure variability as a predictor of acute myocardial infarction in elderly patients receiving antihypertensive therapy", J Hum Hypertens, 16, pp.141~146 (2002)
- Bonilla Rosales IC, "Blood pressure variability in 24 hours in obese and non-obese adolescents with breast development 4 and 5 of Tanner’s criteria", Nutr Hosp, 26, pp.1011~1017 (2011)
- 임윤주, "소아청소년기의 고혈압에서 활동혈압측정의 임상 양상", Clinical Hypertension, 18(1), pp.46~51 (2012), 대한고혈압학회
- World Health Organization, "International Association for the Study of Obesity; International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment" (2000), Health Communications Australia Pty Ltd
- Kim HS, "Correlation between obesity indices and blood pressure", J Korean Soc Hypertens, 3, pp.91~101 (1997)
- Kaplan NM, "Controversies in hypertension", Lancet, 367, pp.168~176 (2006)
- Wolf-Maier K, "Hypertension treatment and control in five European countries, Canada, and the United States", Hypertension, 43, pp.10~17 (2004)
- Barr EL, "Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance : the Australian Diabetes, Obesity, and Lifestyle Study(AusDiab)", Circulation, 116, pp.151~157 (2007)
- Gupta AK, "Prediabetes is associated with abnormal circadian blood pressure variability", J Hum Hypertens, 22, pp.627~633 (2008)
- Gupta AK, "Prediabetes and prehypertension in disease free obese adults correlate with an exacerbated systemic proinflammatory milieu", J Inflamm(Lond), 7, pp.36~ (2010)
- White WB., "How well does ambulatory blood pressure predict target-organ disease and clinical outcome in patients with hypertension?", Blood Press Monit, 4(Suppl 2), pp.S17~S21 (1999)
- Felicio JS, "Nocturnal blood pressure fall as predictor of diabetic nephropathy in hypertensive patients with type 2 diabetes", Cardiovasc Diabetol, 9, pp.36~ (2010)
- Young JB, "Sympathoadrenal activity in human obesity : heterogeneity of findings since 1980", Int J Obes Relat Metab Disord, 16, pp.959~967 (1992)
- Jeppesen J, "C-reactive protein, insulin resistance and risk of cardiovascular disease : a population-based study", Eur J Cardiovasc Prev Rehabil, 15, pp.594~598 (2008)
- Abramson JL, "Body mass index, leptin, and ambulatory blood pressure variability in healthy adults", Atherosclerosis, 214, pp.456~461 (2011)
- Mena L, "A reliable index for the prognostic significance of blood pressure variability", J Hypertens, 23, pp.505~511 (2005)