OBJECTIVE: To examine the relationship between 24 h ambulatory blood pressure monitoring and three commonest anthropometric measurements for obesity -body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (W). DESIGN: Cross-sectional survey among outpatients at the Obesity Research Center. SUBJECTS AND METHODS: Four-hundred and sixty-one overweight or obese subjects, non-diabetic, otherwise healthy, aged 20 -70 y, of either sex, were consecutively recruited. All subjects underwent 24 h ambulatory blood pressure monitoring. The population study was separated in normotensive and hypertensive males and females and the possible risk factors for hypertension (W, WHR, BMI and age) were subdivided into different classes of values. RESULTS: Logistic regression shows that W is the most important anthropometric factor associated with the hypertensive risk. Among males with W!102 cm the odds ratio (OR) for hypertension is three times that of males with W<94 cm using casual BP measure (OR 3.04), nearly four times higher using 24 h BP mean (OR 3.97), and even five times higher using day-time BP mean (OR 5.19). Females with W!88 cm have a risk for hypertension twice that of females with W<80 cm, whatever BP measurement was take (casual, 24 h or day-time). Males with WHR!0.96 and females with WHR!0.86 show significant OR for hypertension only by 24 h BP measurement and by day-time BP measurement. BMI seems to have no significant relationship to hypertensive risk. Age shows a significant relationship to hypertensive risk only considering males aged !55 y and females aged !50 y. CONCLUSION: The waist circumference seems to have a strong association with the risk of hypertension, principally by the ambulatory BP monitoring, when compared with casual BP measurement.
Objective: To study signi®cant factors associated with the risk of hypertension among obese women, with and without a history of weight cycling (WC). Design: Case ± control study. Setting: Obesity Clinic of Chieti University, Italy. Subjects: A group of 258 obese women aged 25 ± 64 y (103 cases with hypertension and 155 controls) were recruited. All obese subjects had the same clinical characteristics, were without a family history for hypertension, were non-smokers, had normal lipidemic pro®les and normal glucose tolerance, were not taking any medication and were otherwise healthy. Intervention: In the weight cycling women, the history of WC was established on the basis of at least ®ve weight losses in the previous 5 y due to dieting, with a weight loss of at least 4.5 kg per cycle. A logistic regression model adjusted for confounding variables such as waist-to-hip ratio (WHR) and weight cycling history parameters was used and the odds ratio (OR) with 95% con®dence intervals was calculated. Results: The risk of hypertension increases in subjects with larger WHR (OR 7.8; 95% CI 3.4 ± 17.9) and with a positive history for WC (OR 4.1; 95% CI 2.4 ± 6.9). Further, in obese patients with WC, the weight cycling index and the sum of the weight regained are also important risk factors for hypertension. Conclusions: These ®ndings could support the hypothesis that it is the combined exposure of central-type obesity and WC that strongly raises the risk of hypertension. Sponsorship: This work has been ®nancially supported by a grant
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