Abstract P079: Leptin And Risk Of Incident Hypertension In The Reasons For Geographic And Racial Differences In Stroke (REGARDS) Cohort Study

Abstract

Background: Leptin is an anorexigenic and sympathoexcitatory adipokine strongly associated with obesity and associated with hypertension in animal models. Whether leptin is associated with hypertension incidence independent of obesity is unclear. Methods: REGARDS recruited 30,239 Black or White adults aged ≥45 years recruited from 48 US contiguous states in 2003-07 with a second visit in 2013-16. Baseline serum leptin was measured by ELISA in a sex- and race-stratified sample of 4,400 REGARDS participants. Modified Poisson regression estimated relative risk (RR) of incident hypertension (140/90 mm Hg threshold or use of antihypertensives) per higher leptin tertile, stratified by a BMI of 30 kg/m 2 , adjusting for known confounders. Results: Among the 1,834 participants without prevalent hypertension (mean [SD] age 62, 56% women, 25% Black adults), median follow-up was 9 years. Incident hypertension developed in 35%. BMI significantly modified the relationship between leptin and incident hypertension (P-interaction <0.001) such that higher leptin was associated with greater hypertension risk in the crude model among those with BMI <30, but not ≥30, kg/m 2 ( Figure ). This association was fully attenuated when adjusting for waist circumference and BMI. Conclusions: Leptin is associated with hypertension among normal weight but not obese adults in REGARDS. Adiposity may be on the causal pathway between leptin levels and obesity.