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Association between non-alcoholic hepatic steatosis and hyper reactive blood pressure response on the exercise
A G Laurinavicius1, M S Bittencourt2, M J Blaha3
1From the Preventive Medicine Center Hospital Israelita Albert Einstein, Av. Brasil, 953, CEP-01431-000, Säo Paulo, Brazil, Lipid Clinic Heart Institute (InCor) University of Sao Paulo, Medical School Hospital, Av. Eneas de Carvalho Aguiar, 44, CEP-05403-900, Säo Paulo, Brazil.
Aims:
Non-alcoholic hepatic steatosis (HS) is associated with hypertension and increased cardiovascular risk. While Blood pressure hyper-reactive response (HRR) during peak exercise indicates an increased risk of incident hypertension and increased cardiovascular risk, no data on the association of non-alcoholic HS and HRR exists. In this study, we have evaluated the association of HS with HRR.
Methods:
We included 13 410 consecutive individuals with a mean age: 42.4 ± 8.9 years, 3561 (26.6%) female with normal resting blood pressure and without a previous diagnosis of hypertension, who underwent symptom limited exercise treadmill test, abdominal ultrasonography and clinical and laboratory evaluation. HS was detected by abdominal ultrasonography. HRR was defined by a peak exercise systolic blood pressure >220 mmHg and/or elevation of 15 mmHg or more in diastolic blood pressure from rest to peak exercise.
Results:
The prevalence of HS was 29.5% (n = 3956). Overall, 4.6% (n = 619) of the study population presented a HRR. Subjects with HS had a higher prevalence of HRR (8.1 vs. 3.1%, odds ratio 2.8, 95% CI 2.4-3.3, P < 0.001). After adjustment for body mass index, waist circumference, fasting plasma glucose and low density lipoprotein cholesterol, HS (odds ratio 1.4, 95% CI 1.1-1.6, P = 0.002) remained independently associated with HRR. HS was additive to obesity markers in predicting exercise HRR.
Conclusions:
Non-alcoholic HS is independently associated with hyper-reactive exercise blood pressure response.
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