Adiposity and Blood Pressure in 110 000 Mexican Adults

We examine the joint association of weight status and leisure-time physical activity on high blood pressure in a nationally representative sample of adults and older adults in Brazil. This was a national cross-sectional survey conducted in Brazil in 2013 (Brazilian Health Survey). The sample consisted of 59 402 participants (56% women, aged 18 to 100 years). Outcome was objectively assessed blood pressure. Body mass index (BMI) was objectively measured, while self-reported information on leisure-time physical activity, TV viewing, chronological age, race, educational status, tobacco smoking, sodium consumption, and hypertension medication was obtained using questionnaires. Logistic regression analysis with adjusted odds ratio was conducted to test the joint association of BMI and leisure-time physical activity categories on high blood pressure. Overall, compared to normal weight (NW) and physically active group, the NW/inactive (OR = 1.28; 1.04 to 1.58), overweight/active (OR = 1.38; 1.08 to 1.78), overweight/inactive (OR = 1.89; 1.53 to 2.33), obese/active (OR = 2.19; 1.59 to 3.01) and obese/inactive (OR = 2.54; 2.05 to 3.15) groups were 28% to 254% more likely to have high blood pressure. The attenuation and high blood pressure was greater for women and adults than for men and older adults. Thus, leisure-time physical inactivity and being overweight and obesity were associated with high blood pressure in Brazilian population. Engaging in sufficient level of physical activity during leisure could attenuate, but not eliminate, the negative influence of obesity on high blood pressure in Brazilian adults and older adults.

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Does leisure‐time physical activity attenuate or eliminate the positive association between obesity and high blood pressure?

Werneck

Oyeyemi

Gerage

et al. 2018

“…Differently from De Pergola et al observation that perirenal fat thickness was associated with an increase in DBP but not in SBP, in our population, we documented a significant correlation between perirenal fat and high SBP; also in the study population, perirenal fat thickness turned out to be an independent predictor of high SBP. Furthermore, the finding of a positive correlation between perirenal fat thickness and WC, a predictor of arterial hypertension, strengthens the hypothesis of its central role in hypertension development in obese subject.…”

Section: Discussionsupporting

confidence: 75%

“…Furthermore, the finding of a positive correlation between perirenal fat thickness and WC, a predictor of arterial hypertension, 15,16 strengthens the hypothesis of its central role in hypertension development in obese subject.…”

Section: Ta B L E 1 Population Characteristics At Baselinesupporting

confidence: 71%

Morbid obesity and hypertension: The role of perirenal fat

Ricci

Scavizzi

Ministrini

et al. 2018

Accumulation of fat in renal sinus and hilum is associated with hypertension development. We evaluated the relationship between perirenal fat and hypertension in a population of morbidly obese patients and the potential variations after sleeve-gastrectomy. Two hundred and eighty-four morbidly obese patients were included in the study, and 126 underwent sleeve-gastrectomy. At baseline and 10-12 months after surgery, we evaluated anthropometric parameters, blood pressure, glycometabolic, and lipidic assessment, and performed an ultrasonographic evaluation of visceral fat area and perirenal fat thickness. The perirenal fat thickness in hypertensive obese was higher than in nonhypertensive (13.6 ± 4.8 vs 11.6 ± 4.1, P = 0.001). It showed a significant direct correlation with age, waist circumference, BMI, systolic blood pressure (SBP), insulinemia, HOMA-IR, glycated hemoglobin, and creatinine. The independent predictors (R = 0.129) of SBP were perirenal fat thickness (β = 0.160, P = 0.022) and age (β = 0.175, P = 0.011). After surgery, perirenal fat thickness significantly decreased (from 13 ± 4 to 9 ± 4 mm, P <0.001). In the 89 hypertensive obese patients who underwent sleeve-gastrectomy, we observed a significant decrease in antihypertensive medications needed. Sixteen patients suspended therapy. The perirenal fat thickness in obese patients could be a valuable tool to define the risk of developing hypertension, providing the clinician with an additional parameter to define those who need a more aggressive treatment and could benefit most from bariatric surgery.

“…However, the relationship between NC and hypertension is not fully understood; some studies suggest that upper‐body subcutaneous fat might increase fatty acid release, induce insulin resistance and cause endothelial damage. On the contrary, some studies suggest that overall adiposity may be more important than central adiposity for blood pressure; suggesting that the predictors for blood pressure may be somewhat different from those for IABPD. Also, NC is highly correlated with obstructive sleep apnea syndrome, a well‐known cardiovascular risk factor .…”

Section: Discussionmentioning

confidence: 99%

Longitudinal association between adiposity and inter‐arm blood pressure difference

Muñoz‐Torres

Andriankaja

Ruíz

et al. 2019

This is the first longitudinal study evaluating whether adiposity is associated with inter‐arm blood pressure difference. We evaluated 714 overweight/obese individuals aged 40‐65 years over a 3‐year follow‐up. Systolic and diastolic blood pressures were measured in both arms simultaneously using an automated machine. Linear regression assessed the associations of body mass index, fat %, waist, neck, thigh, and arm circumferences (cm), with absolute inter‐arm differences in systolic (IAS) and diastolic (IAD) blood pressure (mm Hg). Poisson regression was used for binary outcomes (IAS and IAD ≥ 10 mm Hg). All models were adjusted for age, gender, smoking, physical activity, and HOMA‐IR. Adiposity measures were associated with increased IAS and IAD (β range: 0.09‐0.20 and 0.09‐0.30). Neck circumference showed the strongest association with IAS (β = 0.20, 95% CI: 0.03, 0.37) and IAD (β = 0.30, 95% CI: 0.12, 0.47); arm circumference showed a similar association with IAS, but lower with IAD. Highest quartiles of BMI, thigh, and arm showed significant associations with IAS (IRR: 2.21, 2.46 and 2.70). Highest quartiles of BMI, waist, neck, and arm circumferences were significantly associated with IAD (IRR: 2.38, 2.68, 4.50 and 2.24). If the associations are corroborated in other populations, adiposity may be an important modifiable risk factor for inter‐arm blood pressure difference with a large potential public health impact.