Document Detail


Body mass index, nocturnal fall in blood pressure and organ damage in untreated essential hypertensive patients.
MedLine Citation:
PMID:  19020422     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: We sought to investigate the relationship between body mass index (BMI) and parameters derived from 48-h ambulatory blood pressure monitoring (ABPM) as well as organ damage in human hypertension. METHODS: A total of 658 consecutive outpatients with grade 1 and 2 hypertension, never treated with antihypertensive medications underwent the following procedures: (i) routine examination, (ii) 24-h urine collection for microalbuminuria, (iii) ABPM over two 24-h periods within 4 weeks, (iv) echocardiography and (v) carotid ultrasonography. Each patient was classified as lean (BMI<25 kg/m2) or overweight/obese (> or =25 kg/m2) and according to the consistency of the dipping or nondipping status in the first and second ABPM period, as dipper (DD), nondipper and variable dipper. RESULTS: Mean 48-h, daytime and nighttime systolic BP or diastolic BP were superimposable in the lean (n=314) and overweight (n=344) group. Overweight patients had a reduced nocturnal BP drop compared with their lean counterparts; the prevalence of DD pattern, indeed, was 15% lower in the overweight group as a whole, with a 17% difference in men and 13% in women. The prevalence of left ventricular hypertrophy was higher in overweight than in lean patients (31.8 vs. 15.9% in men and 48.7 vs. 15.6% in women, P<0.01); this more pronounced cardiac involvement was associated with structural carotid alterations. CONCLUSION: This study, the first to investigate the relationship between BMI and nocturnal BP patterns as assessed by two ABPM sessions, shows that overweight hypertensive patients are more likely to have a reduced nocturnal fall in BP and a greater cardiac and extracardiac organ damage as compared with their lean counterparts despite a similar overall BP load.
Authors:
Cesare Cuspidi; Stefano Meani; Cristiana Valerio; Francesca Negri; Carla Sala; Meilikemu Maisaidi; Valentina Giudici; Alberto Zanchetti; Giuseppe Mancia
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Blood pressure monitoring     Volume:  13     ISSN:  1473-5725     ISO Abbreviation:  Blood Press Monit     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-21     Completed Date:  2009-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  318-24     Citation Subset:  IM    
Affiliation:
Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milano, Italy. cesare.cuspidi@unimib.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Albuminuria / physiopathology
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory
Body Mass Index*
Carotid Arteries / physiopathology,  ultrasonography
Circadian Rhythm / physiology*
Echocardiography
Female
Humans
Hypertension / physiopathology*,  ultrasonography
Hypertrophy, Left Ventricular / diagnosis,  epidemiology*,  ultrasonography
Male
Middle Aged
Outpatients
Overweight
Prevalence
Sex Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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