Abstract 23: Visceral Adiposity is Associated with Persistently High and Less Variable Blood Pressure: Results From the Dallas Heart Study

Abstract

Introduction: Hypertension is strongly linked to obesity. Blood pressure variability (BPV), a novel BP phenotype with potential clinical significance, may also be associated with increased adiposity. We aimed to investigate the relationship between body fat distribution and average BP and BPV in the short- and long-term. Methods: Using data from the Dallas Heart Study, we assessed within-visit (short-term) and visit-to-visit (long-term) BPV (average real variability [ARV], defined as the average of absolute differences of BP between successive BP measures) during a 5-month follow-up period (2000-2002). Five BP measures were taken at each of the 3 visits (two in-office and one in-home survey). The associations of visceral (VAT) and abdominal subcutaneous adipose tissue (SAT) quantified by MRI and lower body subcutaneous fat (LBF) by DEXA with BP phenotypes were assessed using multivariable-adjusted linear regression. Results: 2595 participants with mean age 44 years; 54 % women; 68 % non-White; mean BMI 29 kg/m2, mean SBP 127 mmHg and DBP 79 mmHg were included. The short-term ARV of SBP at home and office, and long-term ARV of SBP over 3 visits were 4.0±2.4 mm Hg, 4.1±2.5 mmHg, and 9.8±7.1 mmHg, respectively. VAT, SAT, and LBF were not associated with short-term ARV of SBP, while higher VAT was associated with lower long-term ARV of SBP (Table). VAT was strongly associated with average SBP in the short- and long-term, while higher LBF was associated with lower average SBP in the short- and long-term. Conclusions: Greater VAT is associated with persistently higher short- and long-term average BP with lower variability over visits. The presence of persistently elevated BP, coupled with lower BPV, associated with visceral adiposity may impose higher cardiac workload and consequently increase cardiac hypertrophy and risk for heart failure.