II Clinic of Cardiology and Internal Medicine, Collegium Medicum, School of Medicine, University of Warmia and Mazury in Olsztyn, 11-041 Olsztyn, Poland.
Department of Public Health, Unit of Public Health, University of Warmia and Mazury in Olsztyn, 11-041 Olsztyn, Poland.
Medicina (Kaunas). 2020 Dec 15;56(12):700. doi: 10.3390/medicina56120700.
It is commonly known that obesity not only increases arterial hypertension (HT) risk but also impacts on the response to antihypertensives. This study aimed to assess blood pressure (BP) parameters based on Ambulatory Blood Pressure Measurement (ABPM) in obese patients. The study group consisted of 128 patients with obesity (BMI ≥ 30 kg/m), with an average age of 43.25 years (±12.42), including 55 males and 73 females. They were divided into 2 groups: 1-with BMI ≥ 30 kg/m and <40 kg/m, 2-with BMI ≥ 40 kg/m. Each patient underwent 24-h blood pressure monitoring. The average 24-h, daytime and nighttime systolic and diastolic pressure, as well as 24-h mean heart rate and % of nocturnal dip, were assessed. Mean BMI in group 1 was 34.73 kg/m (±2.96), and in group 2 it was 47.6 kg/m (±6.3). Group 1 was significantly older than group 2 (46.5 vs. 39 years old). The analysis of ABPM revealed significantly higher BP values in all measurements in group 2 (i.e., systolic blood pressure (SBP) 24 h median = 132 mmHg; diastolic blood pressure (DBP) 24 h median = 84 mmHg). The nocturnal dip was greater in group 1 (8.95%). Mean 24-h heart rate was also higher in group 2 (median = 76 beats/min) than group 1 (median = 67.5 beats/min). More than half of patients in group 2 had been previously treated for HT, and based on ABPM, new HT was diagnosed in 6 patients from group 1 and 14 patients from group 2. Three groups of patients were identified based on nighttime dip: dipper, non-dipper, and reverse-dipper. No patient of the extreme dipper type was found. Group 2 comprised of significantly more patients of the reverse-dipper type. : Patients with extreme morbid obesity frequently exhibit HT of the reverse-dipping pattern. This type is often linked with a higher risk of more advanced cardiovascular illness.
众所周知，肥胖不仅会增加患高血压（HT）的风险，还会影响降压药物的疗效。本研究旨在通过动态血压监测（ABPM）评估肥胖患者的血压（BP）参数。研究组包括 128 名肥胖患者（BMI≥30kg/m），平均年龄为 43.25 岁（±12.42），包括 55 名男性和 73 名女性。他们被分为两组：1 组 BMI≥30kg/m 且＜40kg/m，2 组 BMI≥40kg/m。每组患者均进行 24 小时血压监测。评估 24 小时、白天和夜间的收缩压和舒张压平均值，以及 24 小时平均心率和夜间血压下降百分比。1 组的平均 BMI 为 34.73kg/m（±2.96），2 组为 47.6kg/m（±6.3）。1 组明显比 2 组年龄大（46.5 岁比 39 岁）。ABPM 分析显示，2 组所有测量值的血压值均显著升高（即 24 小时收缩压（SBP）中位数=132mmHg；24 小时舒张压（DBP）中位数=84mmHg）。1 组的夜间血压下降幅度更大（8.95%）。2 组的平均 24 小时心率也高于 1 组（中位数=76 次/分钟）（中位数=67.5 次/分钟）。2 组中超过一半的患者曾因 HT 接受过治疗，根据 ABPM，1 组中有 6 例和 2 组中有 14 例新诊断为 HT。根据夜间血压下降情况，将患者分为三组：杓型、非杓型和反杓型。未发现极端杓型患者。2 组中明显有更多的反杓型患者。结论：极度肥胖患者常出现反杓型 HT。这种类型通常与更严重的心血管疾病风险增加有关。
