急性体重歧视暴露对肥胖和高血压女性心血管反应的影响：一项随机试验。

The effects of an acute weight stigma exposure on cardiovascular reactivity among women with obesity and hypertension: A randomized trial.

机构信息

Department of Kinesiology, University of Connecticut, Storrs, CT, United States of America; Department of Research, Hartford Hospital, Hartford, CT, United States of America.

Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, CT, United States of America; Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT, United States of America.

出版信息

J Psychosom Res. 2023 Feb;165:111124. doi: 10.1016/j.jpsychores.2022.111124. Epub 2022 Dec 21.

DOI:10.1016/j.jpsychores.2022.111124

PMID:36571973

Abstract

OBJECTIVE

Weight stigma induces cardiovascular health consequences for people with obesity. How stigma affects cardiovascular reactivity in individuals with both obesity and hypertension is not known.

METHODS

In a randomized experiment, we assessed the influence of two video exposures, depicting either weight stigmatizing (STIGMA) or non-stigmatizing (NEUTRAL) scenes, on cardiovascular reactivity [resting blood pressure (BP), heart rate (HR), ambulatory BP (ABP), and ambulatory HR (AHR)], among women with obesity and high BP (HBP; n=24) or normal BP (NBP; n=25). Systolic ABP reactivity was the primary outcome. Laboratory BP and HR were measured before/during/following the videos, and ABP and AHR were measured over 19 hours (10 awake hours, 9 sleep hours) upon leaving the laboratory. A repeated measures ANCOVA tested differences in BP and HR changes from baseline in the laboratory and over ambulatory conditions between the two groups after each video, controlling for body mass index, baseline BP and HR.

RESULTS

Laboratory SBP/DBP increased 5.5+7.3/2.4+8.8mmHg more in women with HBP than NBP following the STIGMA versus NEUTRAL video (Ps<0.05). For the primary outcome, ABP increased more in HBP than NBP over sleep (SBP/DBP=4.2+20.6/4.7+14.2mmHg; Ps<0.05) following the STIGMA versus NEUTRAL video, as did HR during sleep (7.5+15.7bpm more in HBP than NBP; P<0.05).

CONCLUSIONS

Weight stigma increases cardiovascular reactivity among women with obesity and HBP in the laboratory and under ambulatory conditions.

CLINICAL TRIAL REGISTRATION

Registered at ClinicalTrials.gov (Identifier: NCT04161638).

摘要

目的

体重歧视会对肥胖人群的心血管健康产生影响。目前尚不清楚这种歧视是如何影响肥胖合并高血压人群的心血管反应。

方法

在一项随机实验中，我们评估了两种视频暴露对心血管反应的影响，即描绘体重歧视（STIGMA）或非歧视（NEUTRAL）场景的视频，这些反应包括肥胖合并高血压（HBP；n=24）或正常血压（NBP；n=25）女性的静息血压（BP）、心率（HR）、动态血压（ABP）和动态心率（AHR）。收缩压 ABP 反应性是主要结局。在观看视频前后，实验室测量了 BP 和 HR，离开实验室后，19 小时（10 小时清醒，9 小时睡眠）内测量了 ABP 和 AHR。在观看完每个视频后，重复测量方差分析检验了两组之间实验室和动态条件下从基线到 BP 和 HR 变化的差异，控制了体重指数、基线 BP 和 HR。

结果

与观看中性视频相比，HBP 女性在观看 STIGMA 视频后，实验室 SBP/DBP 分别增加了 5.5+7.3/2.4+8.8mmHg（P<0.05）。对于主要结局，与观看中性视频相比，HBP 女性在睡眠期间 ABP 升高更多（SBP/DBP 分别增加了 4.2+20.6/4.7+14.2mmHg；P<0.05），睡眠期间 HR 也增加更多（HBP 比 NBP 增加了 7.5+15.7bpm；P<0.05）。