Abstract P387: Race and Sex Differences Exist in the Volumes of Visceral Adipose Tissue Associated With Prevalent Hypertension in Middle Age Adults

Abstract

Background: Higher visceral adipose tissue (VAT) volume is associated with greater risk for hypertension (HTN). Although VAT volume and prevalence of HTN vary by sex and race, the differences in VAT volumes associated with identification of individuals with prevalent HTN across these groups is unclear. Objective: To determine VAT volume cut points that maximize true positive, true negative and optimal identification of prevalent HTN and to compare the cut points across sex and race groups. Methods: Data were examined from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a multi-center longitudinal study of the development of cardiovascular risk in black and white men and women ages 18-30 years at baseline. In 2010-11, the Year 25 exam was performed (43-55 years) and VAT volume (cm3) was quantified by computed tomography based on two 5 mm contiguous slices at the level of the 4th-5th lumbar vertebra (n=3,153). HTN was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg and/or anti-hypertension medication use. Receiver operating characteristic (ROC) curve analysis was used to identify VAT volume cut points associated with true positive, true negative and optimal identification of prevalent HTN. Results: Year 25 prevalence of HTN ranged from 18.2% (white women) to 49.4% (black women); mean VAT volume ranged from 113.5 cm3 (white women) to 172.1 cm3 (white men). White males exhibited the highest VAT volumes (22-36% higher) and black women exhibited the lowest VAT volumes (3-50% lower) associated with true positive, true negative and optimal identification of HTN compared to other race/sex groups (Table 1). VAT volumes associated with HTN among black participants were generally lower than those exhibited for whites. Conclusions: Although the utility of VAT alone to identify HTN cases is modest - likely a result of unaccounted HTN confounders - these findings display the distinct race- and sex-specific differences in VAT volumes associated with prevalent HTN in middle age adults.