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

Jessica E Middlemiss; Karen L Miles; Barry J McDonnell; null Yasmin; Kaisa M Maki-Petaja; John R Cockcroft; Ian B Wilkinson; Carmel M McEniery; Enigma study investigators

doi:10.1097/HJH.0000000000000798

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

Jessica E Middlemiss, Karen L Miles, Barry J McDonnell, Yasmin, Kaisa M Maki-Petaja, John R Cockcroft, Ian B Wilkinson, Carmel M McEniery, Enigma study investigators

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: The positive association between adiposity and hypertension is well recognized. However, not all overweight individuals have elevated blood pressure (BP). Moreover, different factors may be associated with high BP in normal-weight versus overweight individuals. The aim of the current study was to examine the influence of adiposity on the relationship between SBP and underlying haemodynamic mechanisms in young adults.

METHOD: Data from 2502 patients were available from the Enigma study. Detailed demographic, biochemical, and haemodynamic data were obtained in all individuals. Data were analysed between lower and upper tertiles of BMI and SBP, separately for each sex.

RESULTS: In normal-weight individuals, cardiac output (CO) was elevated in those with higher SBP, independently of body size. Moreover, higher CO was associated with an increased stroke volume in men (P < 0.001), but an increased heart rate in women (P = 0.002). In contrast, in overweight individuals, peripheral vascular resistance (PVR) was elevated in men with higher SBP (P = 0.02) and those with lower SBP had the lowest PVR of all groups. In linear regression analyses, there was a stronger association between SBP and CO in normal-weight individuals, but a stronger association between SBP and PVR in overweight individuals.

CONCLUSION: Different haemodynamic mechanisms are associated with elevated SBP in young adults, depending on body size and sex. These data suggest the need for differential approaches to the identification and management of young adults with elevated BP.

Original language	English
Pages (from-to)	290-7
Number of pages	8
Journal	Hypertension research: official journal of the Japanese Society of Hypertension
Volume	34
Issue number	2
DOIs	https://doi.org/10.1097/HJH.0000000000000798
Publication status	Published - 29 Feb 2016

Keywords

Adiposity
Adult
Blood Pressure
Body Mass Index
Body Size
Female
Heart Rate
Humans
Hypertension
Male
Overweight
Sex Factors
Stroke Volume
Vascular Resistance
Young Adult

Access to Document

10.1097/HJH.0000000000000798Licence: Unspecified

Cite this

Middlemiss, J. E., Miles, K. L., McDonnell, B. J., Yasmin, Maki-Petaja, K. M., Cockcroft, J. R., Wilkinson, I. B., McEniery, C. M., & Enigma study investigators (2016). Mechanisms underlying elevated SBP differ with adiposity in young adults: the Enigma study. Hypertension research: official journal of the Japanese Society of Hypertension, 34(2), 290-7. https://doi.org/10.1097/HJH.0000000000000798

@article{2d81d958b53d4e85bbb4f969a7151554,

title = "Mechanisms underlying elevated SBP differ with adiposity in young adults: the Enigma study",

abstract = "OBJECTIVES: The positive association between adiposity and hypertension is well recognized. However, not all overweight individuals have elevated blood pressure (BP). Moreover, different factors may be associated with high BP in normal-weight versus overweight individuals. The aim of the current study was to examine the influence of adiposity on the relationship between SBP and underlying haemodynamic mechanisms in young adults.METHOD: Data from 2502 patients were available from the Enigma study. Detailed demographic, biochemical, and haemodynamic data were obtained in all individuals. Data were analysed between lower and upper tertiles of BMI and SBP, separately for each sex.RESULTS: In normal-weight individuals, cardiac output (CO) was elevated in those with higher SBP, independently of body size. Moreover, higher CO was associated with an increased stroke volume in men (P < 0.001), but an increased heart rate in women (P = 0.002). In contrast, in overweight individuals, peripheral vascular resistance (PVR) was elevated in men with higher SBP (P = 0.02) and those with lower SBP had the lowest PVR of all groups. In linear regression analyses, there was a stronger association between SBP and CO in normal-weight individuals, but a stronger association between SBP and PVR in overweight individuals.CONCLUSION: Different haemodynamic mechanisms are associated with elevated SBP in young adults, depending on body size and sex. These data suggest the need for differential approaches to the identification and management of young adults with elevated BP.",

keywords = "Adiposity, Adult, Blood Pressure, Body Mass Index, Body Size, Female, Heart Rate, Humans, Hypertension, Male, Overweight, Sex Factors, Stroke Volume, Vascular Resistance, Young Adult",

author = "Middlemiss, {Jessica E} and Miles, {Karen L} and McDonnell, {Barry J} and Yasmin and Maki-Petaja, {Kaisa M} and Cockcroft, {John R} and Wilkinson, {Ian B} and McEniery, {Carmel M} and {Enigma study investigators}",

year = "2016",

month = feb,

day = "29",

doi = "10.1097/HJH.0000000000000798",

language = "English",

volume = "34",

pages = "290--7",

journal = "Hypertension research: official journal of the Japanese Society of Hypertension",

issn = "0916-9636",

publisher = "Nature Publishing Group",

number = "2",

}

Middlemiss, JE, Miles, KL, McDonnell, BJ, Yasmin, Maki-Petaja, KM, Cockcroft, JR, Wilkinson, IB, McEniery, CM & Enigma study investigators 2016, 'Mechanisms underlying elevated SBP differ with adiposity in young adults: the Enigma study', Hypertension research: official journal of the Japanese Society of Hypertension, vol. 34, no. 2, pp. 290-7. https://doi.org/10.1097/HJH.0000000000000798

TY - JOUR

T1 - Mechanisms underlying elevated SBP differ with adiposity in young adults

T2 - the Enigma study

AU - Middlemiss, Jessica E

AU - Miles, Karen L

AU - McDonnell, Barry J

AU - Yasmin, null

AU - Maki-Petaja, Kaisa M

AU - Cockcroft, John R

AU - Wilkinson, Ian B

AU - McEniery, Carmel M

AU - Enigma study investigators

PY - 2016/2/29

Y1 - 2016/2/29

N2 - OBJECTIVES: The positive association between adiposity and hypertension is well recognized. However, not all overweight individuals have elevated blood pressure (BP). Moreover, different factors may be associated with high BP in normal-weight versus overweight individuals. The aim of the current study was to examine the influence of adiposity on the relationship between SBP and underlying haemodynamic mechanisms in young adults.METHOD: Data from 2502 patients were available from the Enigma study. Detailed demographic, biochemical, and haemodynamic data were obtained in all individuals. Data were analysed between lower and upper tertiles of BMI and SBP, separately for each sex.RESULTS: In normal-weight individuals, cardiac output (CO) was elevated in those with higher SBP, independently of body size. Moreover, higher CO was associated with an increased stroke volume in men (P < 0.001), but an increased heart rate in women (P = 0.002). In contrast, in overweight individuals, peripheral vascular resistance (PVR) was elevated in men with higher SBP (P = 0.02) and those with lower SBP had the lowest PVR of all groups. In linear regression analyses, there was a stronger association between SBP and CO in normal-weight individuals, but a stronger association between SBP and PVR in overweight individuals.CONCLUSION: Different haemodynamic mechanisms are associated with elevated SBP in young adults, depending on body size and sex. These data suggest the need for differential approaches to the identification and management of young adults with elevated BP.

AB - OBJECTIVES: The positive association between adiposity and hypertension is well recognized. However, not all overweight individuals have elevated blood pressure (BP). Moreover, different factors may be associated with high BP in normal-weight versus overweight individuals. The aim of the current study was to examine the influence of adiposity on the relationship between SBP and underlying haemodynamic mechanisms in young adults.METHOD: Data from 2502 patients were available from the Enigma study. Detailed demographic, biochemical, and haemodynamic data were obtained in all individuals. Data were analysed between lower and upper tertiles of BMI and SBP, separately for each sex.RESULTS: In normal-weight individuals, cardiac output (CO) was elevated in those with higher SBP, independently of body size. Moreover, higher CO was associated with an increased stroke volume in men (P < 0.001), but an increased heart rate in women (P = 0.002). In contrast, in overweight individuals, peripheral vascular resistance (PVR) was elevated in men with higher SBP (P = 0.02) and those with lower SBP had the lowest PVR of all groups. In linear regression analyses, there was a stronger association between SBP and CO in normal-weight individuals, but a stronger association between SBP and PVR in overweight individuals.CONCLUSION: Different haemodynamic mechanisms are associated with elevated SBP in young adults, depending on body size and sex. These data suggest the need for differential approaches to the identification and management of young adults with elevated BP.

KW - Adiposity

KW - Adult

KW - Blood Pressure

KW - Body Mass Index

KW - Body Size

KW - Female

KW - Heart Rate

KW - Humans

KW - Hypertension

KW - Male

KW - Overweight

KW - Sex Factors

KW - Stroke Volume

KW - Vascular Resistance

KW - Young Adult

U2 - 10.1097/HJH.0000000000000798

DO - 10.1097/HJH.0000000000000798

M3 - Article

C2 - 26682781

SN - 0916-9636

VL - 34

SP - 290

EP - 297

JO - Hypertension research: official journal of the Japanese Society of Hypertension

JF - Hypertension research: official journal of the Japanese Society of Hypertension

IS - 2

ER -

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

Abstract

Keywords

Access to Document

Fingerprint

Cite this