Abstract
Central obesity and hypertension are common risk factors for the metabolic syndrome, cardiovascular and renal diseases. Studies have shown that it is more difficult to control blood pressure and prevent end-organ damage in obese individuals with hypertension compared to their non-obese counterparts, especially among women. Obese females have a 6 times higher risk of developing hypertension than non-obese females while obese males are at a 1.5 times higher risk of developing hypertension, compared to their non-obese counterparts. Indeed, the inter-relationship between obesity and hypertension is unclear. Adipokines have been proposed to play a mediating role in the relationship between obesity and hypertension and are involved in the pathogenesis of metabolic diseases. Therefore, this study sought to determine the role of adipokines (adiponectin, plasminogen activator inhibitor-1, leptin, and tumor necrosis factor-α) in hypertensive Hong Kong Chinese women with central obesity. A total of 387 women aged 58 ± 11 years who were examined with a 2 × 2 factorial design for central obesity (waist circumference ≥ 80 cm) and hypertension (blood pressure ≥ 140/90 mmHg), were recruited from a pool of 1,492 Hong Kong Chinese adults who were previously screened for metabolic syndrome. Subjects with hyperglycemia, hypertriglyceridemia, and dyslipidemia were excluded to eliminate confounding effects. Our findings revealed that hypertensive women with central obesity had a lower anti-inflammatory status (adiponectin) and a higher pro-inflammatory status (TNF-α) than obese alone or hypertensive alone women. Also, women with central obesity had higher circulatory PAI-1 and leptin concentrations than their non-obese counterparts. We conclude that obesity may shift toward a more pro-inflammatory state and may become more severe in the presence of hypertension or vice versa.
Highlights
Obesity and hypertension are commonly associated with chronic disorders, including metabolic syndrome (MetS), renal disease, stroke, and cardiovascular diseases (Hall, 2000; Frohlich, 2002; Hall et al, 2002; Wofford and Hall, 2004)
This is a cross-sectional study in which blood samples from a total of 387 women were selected from a pool of 1,492 Hong Kong Chinese adults who were previously screened for MetS using the United States National Cholesterol Education Program (NCEP) Expert Panel Adult Treatment Panel (ATP) III guidelines (Siu et al, 2015)
Sensitivity analysis for interaction between waist circumference blood pressure (BP) systolic were found on adiponectin and PAI-1; and, interaction between waist circumference and BP diastolic was found on leptin (Supplementary Table 1)
Summary
Obesity and hypertension are commonly associated with chronic disorders, including metabolic syndrome (MetS), renal disease, stroke, and cardiovascular diseases (Hall, 2000; Frohlich, 2002; Hall et al, 2002; Wofford and Hall, 2004). Obese hypertensive individuals have a higher mortality rate and have an increased risk of cardiovascular diseases compared with non-obese hypertensive individuals (Chiang et al, 1969; Messerli, 1982). Obese individuals have been reported to develop more cardiovascular structural abnormalities, whereas those obese individuals with hypertension have an increased risk of renal insufficiency (Hall, 2000; Frohlich, 2002; Hall et al, 2002; Wofford and Hall, 2004; Lavie et al, 2007). It has been hypothesized that the higher death rate observed in obese hypertensive individuals compared to obese alone individuals may be the result of a combination of several overlapping factors, including the regulation of appetite and satiety, endothelial function, energy expenditure, haemostasis, insulin sensitivity, blood pressure, adipogenesis, fat distribution, and insulin secretion in pancreatic β-cells, all of which have been attributed to obesity and hypertension (Re, 2009)
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