Association of Body Mass Index and Regional Fat Distribution with Blood Pressure Investigated by 24-Hour Ambulatory Blood Pressure Monitoring in Android-Type Obese Women
Abstract
In 46 female outpatients with android-type obesity, body mass index (BMI) 36.6 ± 1.0, waist to hip ratio (WHR) >0.86, and normal glucose tolerance (NGT) who were hypertensive at entry study (blood pressure (BP) > 140/90 mm Hg) and in 10 clinically healthy, nonobese, normotensive women, we evaluated the relationship between BMI, fat mass, WHR, fasting blood glucose, sum of blood glucose levels during oral glucose tolerance test and casual BP levels, 24-h ambulatory BP monitoring (ABP) parameters as the 24-hour mean, day-time mean, night-time mean and, by using a periodic model of cosine regression, MESOR (midline estimating statistic of rhythm), amplitude, acrophase, and baric impact. In android obese women, a negative correlation between ABP levels (day-/night-time, MESOR, and baric impact of systolic BP; night-time and MESOR of diastolic BP) and BMI has been documented. A positive correlation between systolic BP (casual, night-time mean, MESOR, amplitude, and baric impact), diastolic baric impact, and the WHR has been found. No correlation has been demonstrated between ABP monitoring parameters, and BMI, body fat, and WHR in the control group. Our data could suggest that, when enrolling obese subjects, it must be taken into account that obesity is a heterogeneous disorder. There are in fact obese subjects with normal or impaired glucose tolerance, as well as diabetics with moderate to severe obesity and with gynecoid or android-type obesity. In our android obese subjects with NGT, the WHR rather than the BMI was found to be a better predictor of hypertension. The conflicting data on the relationship between obesity and hypertension may be reduced, improving BP measurement methods (ABP monitoring, cuff appropriateness) and using time-qualified measures (MESOR, baric impact).