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Abdominal obesity and hypertension: a double burden to the heart

Paweł Krzesiński1, Adam Stańczyk1, Katarzyna Piotrowicz1

  • 1Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|January 22, 2016
PubMed

Insights

Abdominal obesity in hypertensive patients is linked to impaired cardiac function, affecting both systolic and diastolic performance. This highlights how excess abdominal fat negatively impacts cardiovascular hemodynamics even in early stages.

Area of Science:

  • Cardiology
  • Obesity Research
  • Cardiovascular Physiology

Background:

  • Abdominal obesity (AO) is a significant risk factor for cardiovascular disease in individuals with arterial hypertension (AH).
  • Visceral adipose tissue contributes to fluid retention and activation of the sympathetic nervous and renin-angiotensin-aldosterone systems, influencing hemodynamics.

Purpose of the Study:

  • To investigate the relationship between abdominal obesity and the hemodynamic profile in patients diagnosed with arterial hypertension.
  • To assess how abdominal obesity affects various cardiovascular parameters in hypertensive individuals.

Main Methods:

  • Clinical evaluation of 144 hypertensive patients.
  • Echocardiography to assess left ventricular ejection fraction (LVEF), global longitudinal systolic strain (GLSS), and diastolic function (E/A, E/e').
  • Applanation tonometry for central pulse pressure (CPP) and augmentation index (AI).
  • Impedance cardiography to measure acceleration index (ACI), velocity index (VI), systemic vascular resistance index (SVRI), and total artery compliance (TAC).

Main Results:

  • Obese hypertensives exhibited lower GLSS (-17.2±2.5% vs. -19.0±2.8%) and impaired left ventricular performance indices (VI, ACI) compared to non-obese counterparts.
  • Worse diastolic function was observed in obese hypertensives, indicated by lower e' (9.08±2.69 vs. 10.39±2.34 cm/s) and higher E/e' (7.54±1.81 vs. 6.74±1.40) and E/A ratios (1.02±0.34 vs. 1.15±0.33).
  • No significant differences were found in gender, age, blood pressure, heart rate, LVEF, SVRI, TAC, CPP, or AI between the groups.

Conclusions:

  • Arterial hypertension and abdominal obesity share overlapping detrimental effects on cardiovascular hemodynamics.
  • The combined impact of AH and AO manifests as impaired cardiac function, particularly diastolic dysfunction, even at early, asymptomatic stages.

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