The association between masked hypertension and waist circumference as an obesity-related anthropometric index for metabolic syndrome: the Ohasama study

Asayama, Kei; Satō, Atsushi; Mimura, Akira; Hayashi, Kenjiro; Kikuya, Masahiro; Yasui, Daisaku; Kanno, Atsuhiro; Hara, Azusa; Hirose, Takuo; Obara, Taku; Metoki, Hirohito; Inoue, Ryusuke; Hoshi, Hiroyuki; Satoh, Hiroshi; Imai, Yutaka

doi:10.1038/hr.2009.37

Cited by 34 publications

(25 citation statements)

References 41 publications

(47 reference statements)

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“…8,11 However, only a few studies have assessed HOMA-IR in masked hypertension. [21][22][23][24] A Japanese populationbased study found only nonsignificant differences between masked hypertension, defined with home BP and the other BP groups. 21 Another study performed ambulatory BP measurement on 76 untreated, non-diabetic patients and observed significantly higher HOMA-IR in masked, white-coat and sustained hypertension than in normotension.…”

Section: Insulin Resistancementioning

confidence: 95%

“…Although patients with MS frequently have high-normal or elevated office, home and ambulatory BP levels, only a few studies have touched briefly on MS or insulin resistance in masked hypertension. 5,7,[14][15][16][17][18][19][20][21][22][23][24] Most of these studies were based on selected patient groups [14][15][16][17][18][19][20][22][23][24] and only a few of them reported the criteria used to define MS. [14][15][16] The majority of them did not find any significant differences between BP subgroups.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic risk factors and masked hypertension in the general population: the Finn-Home study

et al. 2014

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The association between masked hypertension and metabolic syndrome (MS) or insulin resistance is unclear. We investigated an untreated nationwide population sample (n = 1582, age 44-74 years). Duplicate office blood pressure (BP) measurements were taken on one visit and duplicate morning and evening home measurements were taken for 7 days. Masked hypertension was defined as office BP < 140/90 mm Hg with home BP ⩾ 135/85 mm Hg. Logistic regression analysis was used to determine the association between masked hypertension and metabolic risk factors. Age- and gender-adjusted odds ratios for metabolic disorder were 2.89 (1.87-4.47), 2.93 (2.15-3.97) and 1.68 (1.05-2.70) in white-coat hypertension, 3.39 (2.00-5.76), 3.86 (2.61-5.72) and 2.77 (1.63-4.70) in masked hypertension, and 7.38 (5.19-10.49), 6.45 (4.92-8.46) and 4.27 (3.00-6.08) in sustained hypertension using European Group for the Study of Insulin Resistance, harmonised MS and homeostasis model assessment of insulin resistance above the 80th percentile criteria. When home BP was used to define MS, masked hypertension moved close to sustained hypertension. The association between masked hypertension and metabolic disorders was related to home BP, body mass index and waist circumference. In conclusion, home BP appears to be a useful method to assess the risk of metabolic disorder. Masked hypertensives would benefit from the use of home BP in the definition of MS.

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Section: Insulin Resistancementioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Metabolic risk factors and masked hypertension in the general population: the Finn-Home study

et al. 2014

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“…Results from urban Japanese men showed that waist-to-hip ratio, but not BMI, was linearly associated with HbA1c, and waist-to-hip ratio was positively associated with serum total cholesterol levels and inversely associated with HDL-cholesterol levels, even after adjusting for BMI (Iso et al 1991 ) . Similar stronger relationships between the variables associated with abdominal obesity (waist circumference and waist-to-hip ratio) and the prevalence of hypertension, diabetes, and accumulation of metabolic abnormalities have been reported in some cross-sectional studies with Japanese participants (Ito et al 2003 ;Hsieh and Muto 2005 ;Huxley et al 2008 ;Kato et al 2008 ;Nakamura et al 2008 ;Asayama et al 2009 ) . In contrast, some reports have shown that the association is similar for BMI and waist circumference (Nakamura et al 2007 ; Obesity in Asia Collaboration 2008 ; Kondo et al 2009 ) , and some reports showed that the relationship to some metabolic abnormalities was stronger for BMI than waist circumference (Sakurai et al , 2008Decoda Study Group 2008 ;Kondo et al 2009 ) .…”

Section: Gender Differences In Anthropometric Indices Refl Ecting Obementioning

confidence: 50%

BMI, Waist Circumference, and Metabolic Syndrome: Lessons from Japanese Perspectives

Sakurai¹,

Ota²,

Miura³

et al. 2012

Handbook of Anthropometry

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The prevalence of overweight and obesity in Japan is much lower than in Western countries: about 30% for Japanese men and 20% for Japanese women. Despite this low rate of obesity, the prevalence of metabolic abnormalities related to cardiovascular risk factors such as hypertension, dyslipidaemia, and diabetes is not lower in Japan than in Western countries. Visceral fat accumulation is also closely associated with metabolic abnormalities in the Japanese. Among the anthropometric variables, waist circumference is an indirect measure of abdominal fat accumulation. The waist circumference cutoff points for the Japanese have been proposed as 90 cm for women and 85 cm for men, which correspond to a 100-cm 2 area of visceral fat at the umbilical level on computed tomography imaging. However, subcutaneous fat strongly influences waist circumference in relatively lean Japanese women, and waist circumference does not effectively predict the existence of metabolic syndrome. In relatively lean Japanese women, BMI rather than waist circumference is reported to be more strongly associated with metabolic syndrome and may be more appropriate as an index for total and abdominal fat accumulation. Normal weight is associated with increased cardiovascular risk factors in Japanese. The difference in the association between obesity and metabolic abnormalities in Asian and Western countries may be due to genetic factors, different lifestyles, or sensitivity to metabolic disorders of obesity. Japanese have more total body fat and visceral fat than Caucasian men with the same degree of obesity, and the difference in body fat distribution also contributes to these differences. Furthermore, there is a J-shaped relationship between waist circumference and subsequent risk for type 2 diabetes in relatively lean Japanese; lower pancreatic B-cell function may also increase the diabetes risk in very lean Japanese. Recently, nonalcoholic fatty liver disease has been reported to be closely associated with metabolic syndrome in Western and Asian populations. Not only fat accumulation in the visceral area, but fat accumulation in the liver may also contribute to the development of metabolic syndrome. Therefore, when we consider the association between obesity indices, such as waist circumference and BMI, and metabolic syndrome, we should consider the gender/ethnic differences of these associations, insulin deficiency, and fatty liver-associated insulin resistance.

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“…95 Further, in the International Database in Ambulatory blood pressure in relation to Cardiovascular Outcomes showed a difficult in BP control in diabetes subjects with MHT, with worst outcomes, so the clinician may pay particular attention in BP control of this group. 96 Despite the increased adoption of HBPM and clear utility for diagnosis, as demonstrated in obese patients, 97 ABPM remain the best method to correctly assess the cardiovascular prognosis also at follow-up. 98 …”

Section: Managementmentioning

confidence: 99%

White-coat hypertension and masked hypertension: an update

2015

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The precise quantification of blood pressure (BP) is an essential step to reach the largest number of correct diagnosis of arterial hypertension (AH) and consequently to optimize the anti-hypertensive therapy. Since the invention of the first sphygmomanometer in 1896, Riva-Rocci observed the inaccuracy of that method for a correct BP determination: 1 the simple appearance of a doctor was accompanied by an immediate rise in BP in some patients. Years later Pickering called this phenomenon white coat hypertension (WCHT). 2 The introduction of fully-automated BP measurement during the 24 h (ambulatory blood pressure monitoring, ABPM) allowed to observe the entire circadian BP profile, highlighting how BP could be normal in physician office and elevated at home, especially during the nocturnal period. 3 This last observation was named masked hypertension (MHT). 4 WCHT is defined as office BP persistently ≥140 mmHg systolic, ≥90 mmHG diastolic, or both, whereas out-of-office BP is within normal (<130/80 mmHg for 24-h mean BP, or <135/85 mmHG for home BP). 5-7 Medical environment triggers this alarm reaction, 8 through the hyperactivation of sympathetic nervous system. 9 It peaked 2-4 min after the start of the visit and continued throughout the duration of the physician's visit. 10 For this reason, international guidelines recommended to record at least two ABPM to confirm the diagnosis of WCHT and to determine the possible development of sustained hypertension. 11 Further WCHT can be divided into true WCH, when both home BP values and ABPM values are normal, and partial WCHT, when only one of these out-of-office measurements is normal. 5 If WCHT can determinate an overdiagnosis of AH, on the other hand some subjects present normal office BP values in contrast to pathological 24-h BP profile on ABPM or altered home BP. This reverse white-coat effect or MHT 12,13 is related to a worse cardiovascular (CV) prognosis 14 and also to the development of a target organ damage (TOD) comparable to sustained hypertension patients 15 (Table 1). Both WCHT and MHT are examples of how the correct evaluation of BP profile is a difficult challenge and how their better knowledge can lead to a more precise diagnosis and consequently to a proper treatment of AH. EpidemiologyThe prevalence of WCHT and MHT is not completely clear. AS a confounding factor several studies showed different values for normal BP. Regarding White-coat hypertension and masked hypertension: an update ABSTRACTWhite coat hypertension and masked hypertension are two conditions with a controversial role in the beginning and the progression of the cardiovascular disease. We focused our attention on the definition, the epidemiology, the pathophysiology and the clinical consequences of these two conditions, with an attention also on the management. This review was based on the papers found on PubMed and MEDLINE up to August 2015. The search terms used were white coat hypertension, masked hypertension in combination with epidemiology, management and pathophysiology.

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The association between masked hypertension and waist circumference as an obesity-related anthropometric index for metabolic syndrome: the Ohasama study

Cited by 34 publications

References 41 publications

Metabolic risk factors and masked hypertension in the general population: the Finn-Home study

Metabolic risk factors and masked hypertension in the general population: the Finn-Home study

BMI, Waist Circumference, and Metabolic Syndrome: Lessons from Japanese Perspectives

White-coat hypertension and masked hypertension: an update

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