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Obesity in Hypertensive Patients Is Characterized by a Dawn Phenomenon in Systolic Blood Pressure Values and
Dawid Lipski1, Dorota Marzyńska1, Paulina Sytek1
1Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznan, Poland.
Insights
Obesity significantly impacts hypertension, showing higher blood pressure and variability, especially before waking. This highlights the need to consider weight in managing high blood pressure and cardiovascular risk.
Area of Science:
- Cardiology
- Metabolic Health
- Hypertension Research
Background:
- Excess weight gain is a significant contributor to hypertension.
- Ambulatory blood pressure monitoring (ABPM) is crucial for diagnosing and managing hypertension, offering better cardiovascular risk prediction than office monitoring.
- Understanding how obesity affects blood pressure patterns and variability is vital for effective patient management.
Purpose of the Study:
- To compare hourly blood pressure values and variability between hypertensive patients with and without obesity.
- To investigate the impact of obesity on blood pressure during different sleep-wake cycles.
- To determine if obesity influences short-term blood pressure variability.
Main Methods:
- 1345 hypertensive patients underwent 24-hour ambulatory blood pressure monitoring (ABPM).
- Patients were stratified into groups based on body mass index (BMI) and waist circumference.
- Systolic and diastolic blood pressure variability was calculated using the mean of absolute differences between consecutive measurements.
Main Results:
- Obese individuals exhibited significantly higher systolic blood pressure 1-5 hours before waking compared to normal-weighted individuals.
- Increased body mass index correlated with higher systolic and diastolic blood pressure variability.
- The most pronounced differences in blood pressure and variability were observed in obese patients during the final 5 hours of sleep.
Conclusions:
- Obesity significantly alters nocturnal blood pressure patterns and increases blood pressure variability in hypertensive patients.
- These findings suggest that obesity exacerbates hypertension, particularly in the pre-waking hours.
- ABPM data reveals distinct blood pressure dynamics in obese hypertensive individuals, emphasizing the importance of weight management in hypertension care.
Abstract:
One of the causes of hypertension is excess weight gain, which can also affect the course of this disease. Both the diagnosis and management of hypertension commonly use ambulatory blood pressure monitoring; the results of which correlate more strongly with cardiovascular diseases and cardiovascular death than office blood pressure monitoring. We evaluated blood pressure values and their variability from hour to hour to see if and when they differed between hypertensive patients with and without obesity. The study included 1345 patients who underwent 24 h ambulatory blood pressure monitoring and then were divided into groups according to body mass index and waist circumference. The obtained data were analyzed according to the subjects' wake-up time, and short-term blood pressure variability parameters were calculated as the mean of the absolute values of the differences between consecutive measurements. The systolic blood pressure in obese subjects was significantly higher between 1 and 5 h before waking than in normal-weighted individuals. In turn, the variability in systolic and diastolic blood pressure was higher with increasing body mass index. The difference in systolic blood pressure values and blood pressure variability was most prominent in the last 5 h of sleep in obese patients.
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