Armas-Padrón Ana María, Sicilia-Sosvilla Miriam, Ruiz-Esteban Pedro, Torres Armando, Hernández Domingo
La Cuesta Primary Healthcare Centre, Universidad de la Laguna, La Laguna, E-38320 Tenerife, Spain.
Nephrology Department, Hospital Regional Universitario de Málaga, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA) Plataforma BIONAND, REDinREN (RD16/0009/0006) and RICORS2040 (RD21/0005/0012), E-29010 Málaga, Spain.
J Cardiovasc Dev Dis. 2023 Jul 13;10(7):300. doi: 10.3390/jcdd10070300.
The relationship between poorer cardiovascular health metrics (CVHM) plus low-grade inflammation (LGI) and hypertension-mediated organ damage (HMOD) and hypertension-related comorbidities (HRC) in hypertensive populations with an overweight/obese (Ow/Ob) hypertension-related phenotype is understudied. We examined the relationship between the CVHM score and the presence of LGI and Ow/Ob hypertension-associated phenotype morbidities and mortality in 243 hypertensive patients from an urban primary care center. We recorded the baseline CVHM score plus clinical data, including hs-C-reactive protein (CRP) and prevalent and incident HMOD-HRC and death. A total of 26 (10.7%) had a body mass index (BMI) < 25 kg/m, 95 (31.1%) were overweight (BMI 25-29.9 kg/m), and 122 (50.2%) were obese (BMI ≥ 30 kg/m). There were 264 cases of HMOD-HRC and 9 deaths. Higher hs-CRP levels were observed as BMI increased. Linear regression analysis showed a significant correlation between BMI and hs-CRP, adjusted for confounders. Additionally, individuals with a higher hs-CRP tertile had a significant increase in BMI. Significantly lower log hs-CRP levels were found as the number of ideal CVHM scores rose. Multivariate binary logistic regression found the risk of HMOD-HRC increased significantly as the ideal CVHM scores decreased, and hs-CRP levels also correlated with HMOD-HRC in the whole cohort and in the Ow and Ob subpopulations. These findings highlight the need for early intervention targeting ideal CVHMs among hypertensive individuals with an Ow/Ob phenotype in order to attenuate the inflammatory state and prevent cardiovascular disease.
在具有超重/肥胖(Ow/Ob)高血压相关表型的高血压人群中,较差的心血管健康指标(CVHM)加上低度炎症(LGI)与高血压介导的器官损害(HMOD)以及高血压相关合并症(HRC)之间的关系尚未得到充分研究。我们在一家城市初级保健中心的243名高血压患者中,研究了CVHM评分与LGI的存在以及Ow/Ob高血压相关表型的发病率和死亡率之间的关系。我们记录了基线CVHM评分以及临床数据,包括高敏C反应蛋白(CRP)、HMOD-HRC的患病率和发病率以及死亡情况。共有26人(10.7%)体重指数(BMI)<25kg/m²,95人(31.1%)超重(BMI 25 - 29.9kg/m²),122人(50.2%)肥胖(BMI≥30kg/m²)。有264例HMOD-HRC和9例死亡。随着BMI的增加,观察到hs-CRP水平升高。经混杂因素调整后的线性回归分析显示,BMI与hs-CRP之间存在显著相关性。此外,hs-CRP三分位数较高的个体BMI显著增加。随着理想CVHM评分数量的增加,发现log hs-CRP水平显著降低。多变量二元逻辑回归发现,随着理想CVHM评分降低,HMOD-HRC的风险显著增加,并且hs-CRP水平在整个队列以及Ow和Ob亚组中也与HMOD-HRC相关。这些发现强调了在具有Ow/Ob表型的高血压个体中,针对理想CVHM进行早期干预以减轻炎症状态并预防心血管疾病的必要性。