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Cross-sectional study of the association between day-to-day home blood pressure variability and visceral fat area measured using the dual impedance method.

ABSTRACT: BACKGROUND:The blood pressure (BP) variability (BPV) is a predictor of cardiovascular disease, independently of the BP itself. In addition, visceral fat accumulation can trigger atherosclerotic disease through various mechanisms. METHODS AND RESULTS:We examined the association between fat accumulation and day-to-day BPV in 61 adult hypertensive patients. Visceral fat area (VFA) was measured using the dual bioelectrical impedance analysis method. Participants were divided into three groups based on VFA. The standard deviation (SD) in home systolic BP (SBP) for 7 consecutive days was significantly lower in the high VFA tertile (low VFA, 8.40±4.15 mmHg; intermediate VFA, 8.47±2.80 mmHg; and high VFA, 5.84±2.37 mmHg, p of One-way ANOVA = 0.017, p for trend = 0.0126). A similar association was observed between the coefficient of variance (CV) of home SBP and the VFA tertile. Multiple-regression analysis adjusted for age, sex, antihypertensive drug, diabetes, habitual drinking, and SBP level also showed a significant association between the VFA tertile and the SD or CV of home SBP. The adjusted coefficient of regression for the SD of home SBP was -3.28 (95%CI: -5.60 to -0.97, p = 0.008) and the CV of home SBP was -2.51 (95%CI: -4.31 to -0.71, p = 0.008) for the highest VFA tertile as compared to the lowest VFA tertile. CONCLUSIONS:These results show for the first time negative correlation between VFA and day-to-day BPV. The degree of obesity should be taken into account when evaluating the value of BPV.

SUBMITTER: Kuwabara J

PROVIDER: S-EPMC6218081 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Cross-sectional study of the association between day-to-day home blood pressure variability and visceral fat area measured using the dual impedance method.

Kuwabara Junko J Kuwahara Koichiro K Kuwabara Yoshihiro Y Yasuno Shinji S Nakagawa Yasuaki Y Ueshima Kenji K Kimura Takeshi T

PloS one 20181105 11

<h4>Background</h4>The blood pressure (BP) variability (BPV) is a predictor of cardiovascular disease, independently of the BP itself. In addition, visceral fat accumulation can trigger atherosclerotic disease through various mechanisms.<h4>Methods and results</h4>We examined the association between fat accumulation and day-to-day BPV in 61 adult hypertensive patients. Visceral fat area (VFA) was measured using the dual bioelectrical impedance analysis method. Participants were divided into thre ...[more]

PMID: 30395594

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Project description:BackgroundRecent literature suggests that blood pressure variability (BPV) predicts outcome beyond blood pressure level (BPL) and that antihypertensive drug classes differentially influence BPV. We compared calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockade for effects on changes in self-measured home BPL and BPV and for their prognostic significance in newly treated hypertensive patients.Methods and resultsWe enrolled 2484 patients randomly allocated to first-line treatment with a calcium channel blocker (n=833), an angiotensin-converting enzyme inhibitor (n=821), or angiotensin receptor blockade (n=830). Home blood pressures in the morning and evening were measured for 5 days off treatment before randomization and for 5 days after 2 to 4 weeks of randomized drug treatment. We assessed BPL and BPV changes as estimated by variability independent of the mean and compared cardiovascular outcomes. Home BPL response in each group was significant (P≤0.0001) but small in the angiotensin-converting enzyme inhibitor group (systolic/diastolic: 4.6/2.8 mm Hg) compared with the groups treated with a calcium channel blocker (systolic/diastolic: 8.3/3.9 mm Hg) and angiotensin receptor blockade (systolic/diastolic: 8.2/4.5 mm Hg). In multivariable adjusted analyses, changes in home variability independent of the mean did not differ among the 3 drug classes (P≥0.054). Evening variability independent of the mean before treatment significantly predicted hard cardiovascular events independent of the corresponding home BPL (P≤0.022), whereas BPV did not predict any cardiovascular outcome based on the morning measurement (P≥0.056). Home BPV captured after monotherapy had no predictive power for cardiovascular outcome (P≥0.22).ConclusionsSelf-measured home evening BPV estimated by variability independent of the mean had prognostic significance, whereas antihypertensive drug classes had no significant impact on BPV changes. Home BPL should remain the primary focus for risk stratification and treatment.Clinical trial registrationURL: http://www.umin.ac.jp/ctr/index.htm. Unique identifier: C000000137.

Project description:BACKGROUND:Visceral fat area (VFA) is a good surrogate marker of obesity-related disorders, such as hypertension, dyslipidemia and glucose intolerance. Although estimating the VFA by X-ray computed tomography (CT) is the primary index for visceral obesity, it is expensive and requires invasive radiation exposure. Dual bioelectrical impedance analysis (BIA) is a simple and reliable method to estimate VFA; however, the clinical usefulness of dual BIA remains unclear in patients with type 2 diabetes (T2D). METHODS:We estimated the VFAs by dual BIA and CT in 98 patients with T2D and assessed anthropometric parameters, blood test results, and the presence of comorbid hypertension and dyslipidemia. We compared the correlation between the VFAs examined by dual BIA and CT. Furthermore, we performed the receiver operating characteristic (ROC) analyses for the VFAs to detect the presence of comorbid hypertension and/or dyslipidemia with T2D, which are major comorbidities of visceral obesity, and estimated the area under the curve (AUC). RESULTS:The measurement error between the VFAs by dual BIA and CT was significantly higher among patients with brain natriuretic peptide (BNP)???100 pg/mL than those with BNP?<?100 pg/mL (39.2%?±?31.1% vs. 24.1%?±?18.6%, P?<?0.05). After excluding patients with BNP???100 pg/mL, the VFA by dual BIA significantly correlated with the VFA by CT (r?=?0.917; P?<?0.0001). The AUC in the ROC analysis for the VFA by dual BIA to detect the presence of comorbid hypertension and/or dyslipidemia with T2D was almost equivalent to that for the VFA by CT. CONCLUSIONS:In patients with T2D without elevated BNP?>?100 pg/mL as indicator for fluid accumulation interfering with BIA, estimation of the VFA by dual BIA significantly correlated with that by CT and also detected comorbid hypertension and/or dyslipidemia with T2D equivalent to those detected by CT. Hence, dual BIA could be an alternative to CT as a standard method for estimating the VFA in patients with diabetes.

Project description:PurposeThe aim was to use accelerometer data to describe day-to-day variability in physical activity in a single week, according to sociodemographic variables, in mid-aged Australian adults.MethodsData were from participants in the How Areas in Brisbane Influence HealTh and AcTivity (HABITAT) study who took part in a 2014 sub-study (N = 612; Mean age 60.6 [SD 6.9; range 48-73]). Participants wore a triaxial accelerometer (ActiGraph wGT3X-BT) on their non-dominant wrist for seven days, and data were expressed as acceleration in gravitational equivalent units (1 mg = 0.001 g). These were, used to estimate daily acceleration (during waking hours) and daily time spent in moderate-vigorous physical activity (MVPA, defined as ≥ 100mg). Coefficient of variation (calculated as [standard deviation/mean of acceleration and MVPA across the seven measurement days] * 100%) was used to describe day-to-day variability.ResultsAverage values for both acceleration (24.1-24.8 mg/day) and MVPA (75.9-79.7 mins/day) were consistent across days of the week, suggesting little day-to-day variability (at the group level). However, over seven days, average individual day-to-day variability in acceleration was 18.8% (SD 9.3%; range 3.4-87.7%) and in MVPA was 35.4% (SD 15.6%; range 7.3-124.6%), indicating considerable day-to-day variability in some participants. While blue collar workers had the highest average acceleration (28.6 mg/day) and MVPA (102.5 mins/day), their day-to-day variability was low (18.3% for acceleration and 31.9% for MVPA). In contrast, variability in acceleration was highest in men, those in professional occupations and those with high income; and variability in MVPA was higher in men than in women.ConclusionResults show group-level estimates of average acceleration and MVPA in a single week conceal considerable day-to-day variation in how mid-age Australians accumulate their acceleration and MVPA on a daily basis. Overall, there was no clear relationship between overall volume of activity and variability. Future studies with larger sample sizes and longitudinal data are needed to build on the findings from this study and increase the generalisability of these findings to other population groups.

Dataset Information

Cross-sectional study of the association between day-to-day home blood pressure variability and visceral fat area measured using the dual impedance method.

Publications

Cross-sectional study of the association between day-to-day home blood pressure variability and visceral fat area measured using the dual impedance method.

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