Is obesity predictive of cardiovascular dysfunction independent of cardiovascular risk factors?

• Published in: International Journal of Obesity 2015-02, Vol.39 (2), p.244-253
• Main Authors: DeVallance, E, Fournier, S B, Donley, D A, Bonner, D E, Lee, K, Frisbee, J C, Chantler, P D
• Format: Article
• Language: English
• Subjects: 631/378/1488/393; 692/499; 692/699/75; Adaptation; Adult; Blood Pressure; Body fat; Body mass index; Body size; Cardiac stress tests; Cardiovascular diseases; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Cardiovascular Diseases - physiopathology; Comorbidity; Complications and side effects; Cross-Sectional Studies; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - etiology; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Angiopathies - mortality; Diabetic Angiopathies - physiopathology; Diameters; Doppler effect; Epidemiology; Exercise physiology; Female; Health Promotion and Disease Prevention; Health risk assessment; Health risks; Heart; Heart failure; Humans; Hypertension; Hypertension - etiology; Hypertension - mortality; Hypertension - physiopathology; Internal Medicine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Muscle contraction; Obesity; Obesity - complications; Obesity - mortality; Obesity - physiopathology; original-article; Physical fitness; Physiological aspects; Prognosis; Public Health; Regression analysis; Regression models; Risk analysis; Risk Factors; Systolic pressure; Triglycerides; Triglycerides - metabolism; Ultrasonic imaging; Ultrasound; United States - epidemiology; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - physiopathology; Wave velocity
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/ijo.2014.111

Introduction: Obesity is thought to exert detrimental effects on the cardiovascular (CV) system. However, this relationship is impacted by the co-occurrence of CV risk factors, type 2 diabetes (T2DM) and overt disease. We examined the relationships between obesity, assessed by body mass index (BMI) and waist circumference (WC), and CV function in 102 subjects without overt CV disease. We hypothesized that obesity would be independently predictive of CV remodeling and functional differences, especially at peak exercise. Methods: Brachial (bSBP) and central (cSBP) systolic pressure, carotid-to-femoral pulse wave velocity (PWVcf) augmentation index (AGI; by SphygmoCor), and carotid remodeling (B-mode ultrasound) were examined at rest. Further, peak exercise cardiac imaging (Doppler ultrasound) was performed to measure the coupling between the heart and arterial system. Results: In backward elimination regression models, accounting for CV risk factors, neither BMI nor WC were predictors of carotid thickness or PWVcf; rather age, triglycerides and hypertension were the main determinants. However, BMI and WC predicted carotid cross-sectional area and lumen diameter. When examining the relationship between body size and SBP, BMI ( β =0.32) and WC ( β =0.25) were predictors of bSBP ( P