Daily calorie intake and efficacy of 24-hours blood pressure control in hypertensive patients with obesity on stable antihypertensive therapy

Abstract

Abstract Although it has been established that excessive daily calorie intake contributes to the development of hypertension, the relation between daily energy consumption and blood pressure in patients on stable antihypertensive therapy is not yet known. The aim of the study was to evaluate the relation between daily calorie intake and 24 hours blood pressure control in patients on stable antihypertensive therapy. Materials and methods Cross-sectional study included 141 hypertensive patients with age median 56.5 (45.00 ÷ 63.70) years old. All hypertensive patients had been on the stable antihypertensive therapy during three months and had target office blood pressure at the moment of inclusion to the study. Ambulatory blood pressure monitoring (ABPM) was done to all patients with Heaco ABPM50 monitoring. Physical activity was assessed using International Physical Activity Questionnaire (kcal/week). Patients full in daily dietary diaries and mean daily calorie intake for three days was calculated with standardized soft “Test of Rational Nutrition” (TRP-D02, Ukraine). Fasting glucose, HbA1c, blood lipids, uric acids, creatinine, C-reactive protein were assessed in all patients. Data were analyzed with SPSS IBM 19.0. Results Mean office systolic blood pressure (SBP) was 128.5±11.3 mmHg and diastolic blood pressure (DBP) was 78.5±9.1 mmHg; mean body mass index (BMI) was 34.7±6.2 kg/m2. All patients were divided into three groups according to daily calorie intake: in the 1st group (n=21) patients daily intook less than 1372.2 kcal per day, in the 2nd group (n=58) daily calorie intake was between 1373.2 and 2976.3 kcal per day and in the 3rd (n=62) group subjects intook more than 2977.5 kcal per day. Body mass index in groups 1, 2 and 3 corresponds to 30.34±5.1, 35.1±8.9 and 34.3±6.9 kg/m2, ANOVA test F=2.3, p=0.10. The physical activity level was low in all three groups and did not differs significantly between groups. Results of ambulatory blood pressure monitoring are presented in the table 1. It was observed that high daily calorie intake contributes to non-satisfactory blood pressure control according to ABPM. The odd ratio of day SBP higher than target level in the 2nd group was 1.21 (95% CI, 0.42–4.51) and in the 3rd group 2.67 (95% CI, 0.67–11.70). The odd ratio of day DBP higher than target level was in the 2nd group was 1.19 (95% CI, 0.33–3.50) and in the 3rd group 2.12 (95% CI, 0.61–7.79). The odd ratio of night SBP higher than target level was 2.81 (95% CI, 0.33–10.51) and for DBP 2.88 (95% CI, 0.37–9.43). Conclusion In hypertensive patients with obesity on stable antihypertensive therapy with target office blood pressure high calorie intake contributes to non-satisfactory day and night blood pressure control. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Academy of Medical Science of Ukraine