Mechanisms underlying elevated SBP differ with adiposity in young adults: the Enigma study

Area of Science:

• Cardiovascular Physiology
• Obesity Research
• Hypertension Mechanisms

Background:

• The link between obesity and hypertension is established, but individual responses vary.
• Hemodynamic factors contributing to high blood pressure (BP) may differ based on body weight.
• Understanding these differences is crucial for targeted interventions.

Purpose of the Study:

• To investigate how adiposity affects the relationship between systolic blood pressure (SBP) and underlying hemodynamic mechanisms in young adults.
• To identify distinct hemodynamic profiles associated with elevated SBP in normal-weight versus overweight young individuals.

Main Methods:

• Analysis of demographic, biochemical, and hemodynamic data from 2502 participants in the Enigma study.
• Comparison of individuals within the lower and upper tertiles of body mass index (BMI) and SBP, stratified by sex.
• Linear regression to assess associations between SBP and hemodynamic parameters.

Main Results:

• In normal-weight individuals, higher SBP correlated with elevated cardiac output (CO), driven by stroke volume in men and heart rate in women.
• In overweight individuals, higher SBP was linked to increased peripheral vascular resistance (PVR) in men.
• Regression analyses revealed a stronger SBP-CO association in normal-weight individuals and a stronger SBP-PVR association in overweight individuals.

Conclusions:

• Elevated SBP in young adults is associated with distinct hemodynamic mechanisms (CO vs. PVR) that vary by body size and sex.
• These findings highlight the need for personalized strategies in identifying and managing hypertension in young adults.
• Sex-specific and weight-adjusted approaches are essential for effective BP management.