Murden Raphiel J, Fields Nicole D, Martin Zachary T, Risk Benjamin B, Alonso Alvaro, Manatunga Amita, Erving Christy L, Moore Reneé, Udaipuria Shivika, Quyyumi Arshed, Vaccarino Viola, Lewis Tené T
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Obesity (Silver Spring). 2025 Mar;33(3):589-598. doi: 10.1002/oby.24230. Epub 2025 Feb 19.
Studies of body size and blood pressure (BP) in African American women typically focus on obesity overall or collapse obesity classes II and III into a single subgroup, ignoring potential heterogeneity in associations across categories. Moreover, ambulatory BP outcomes are primarily analyzed as mean daytime and/or nighttime BP, without examination of circadian changes during the day-to-night transition or the full 24-h cycle.
Functional data analysis methods were used to examine whether obesity categories modified ambulatory monitoring-assessed BP circadian rhythm in a cohort of 407 African American women.
Age-adjusted systolic BP (SBP) was 4 mm Hg (95% CI: 0.4-8.4) higher among women with class I or II obesity than those with normal weight or overweight from 12:30 p.m. through 8:00 a.m. Age-adjusted differences in SBP among women with class III obesity versus those with normal weight or overweight were 6 mm Hg (95% CI: 0.7-10.8) during daytime hours and increased to 11 mm Hg (95% CI: 5.8-16.0) overnight. Compared with all other BMI categories, SBP of women with class III obesity declined more slowly from day to night.
Circadian BP among African American women was distinct among those with class III obesity compared with those with other body weight categories, suggesting that intervention efforts in African American women should target this group.
对非裔美国女性的体型与血压（BP）的研究通常聚焦于总体肥胖情况，或将肥胖Ⅱ级和Ⅲ级归为一个亚组，而忽略了不同类别之间关联的潜在异质性。此外，动态血压结果主要分析为日间和/或夜间平均血压，未考察昼夜交替期间或完整24小时周期内的昼夜变化。
采用功能数据分析方法，在407名非裔美国女性队列中，研究肥胖类别是否会改变动态监测评估的血压昼夜节律。
从下午12:30至上午8:00，Ⅰ级或Ⅱ级肥胖女性的年龄调整收缩压（SBP）比体重正常或超重的女性高4 mmHg（95%CI：0.4-8.4）。Ⅲ级肥胖女性与体重正常或超重女性相比，日间SBP的年龄调整差异为6 mmHg（95%CI：0.7-10.8），夜间则增至11 mmHg（95%CI：5.8-16.0）。与所有其他BMI类别相比，Ⅲ级肥胖女性的SBP从白天到晚上下降得更慢。
与其他体重类别的非裔美国女性相比，Ⅲ级肥胖女性的血压昼夜节律明显不同，这表明针对非裔美国女性的干预措施应针对这一群体。
