Cardiometabolic Disorders in Hypertensive Women with Abdominal Obesity.
Abstract
Background:
Studies show increased waist circumference as a relevant indicator of increased cardiovascular risk(CVR).
Objective:
To identify structural and functional cardiac abnormalities in nondiabetic hypertensive women withabdominal obesity (AO).
Methods:
Cross-sectional study with 120 hypertensive women, aged 40-65, stratied into: group with no abdominalobesity (NAO, n=42) and with abdominal obesity (QAO, n=78), and waist circumference < or ≥88 cm, respectively.Clinical evaluation, biochemical tests, Doppler echocardiography and carotid ultrasound were conducted.
Results:
Average age was 53±1 in the groups. Although the systolic blood pressure (BP) was higher in the WAO
group, it did not reach statistical significance (145±2 mmHg vs. 140±2 mmHg, p=0.098). The WAO group hadhigher diastolic BP (90±1 mmHg vs. 85±1 mmHg, p<0.05), greater number of criteria (3.1±0.1 vs. 1.4±0.1, p<0.001)and prevalence of metabolic syndrome (62.8% vs. 11.9%; p<0.001). Despite normal blood glucose levels, WAOpatients had higher HOMA-IR levels (2.62±0.22 vs. 1.61±0.17 p<0.01) and HOMA-beta levels (358±57 vs. 200±22,p<0.05). In the echocardiographic evaluation, systolic function was similar in both groups, but the WAO grouppresented evidence of diastolic dysfunction by tissue Doppler and higher prevalence of left ventricular hypertrophy(29.2% vs. 2.4%), with no difference between the carotid artery intima-media thickness.
Conclusions:
In this sample of nondiabetic hypertensive women, abdominal obesity was associated with higherlevels of diastolic blood pressure, reduced insulin sensitivity and cardiac issues, especially left ventricularhypertrophy and diastolic dysfunction. However, there was no evidence of subclinical carotid atherosclerosis inhypertensive patients with and without abdominal obesity.
Keywords:
Hypertension; Abdominal obesity; Insulin resistance; Metabolic X syndrome; Cardiovascular system