Investigation of subtypes of hypertension and related factors in obese individuals

Yıl 2024, Cilt: 41 Sayı: 3, 552 - 556, 30.09.2024

Sami Bahçebaşı , Banu Açmaz

Öz

Both systolic and diastolic hypertension (HT) have been associated with insulin resistance. There are also studies showing a relationship between insulin resistance and systolic hypertension, but not with diastolic hypertension. This issue is controversial. In this study, we examined the relationship between hypertension subgroups and obesity and insulin resistance. Our study is retrospective and 391obese individuals were divided into 2 groups: normotension group and newly diagnosed hypertension group. The risk of HT in men was found to be 2.4 times higher than in women. The risk of HT was found to be 2.9 times higher in the group with insulin resistance. While there was a positive relationship between systolic blood pressure and CRP and HOMA-IR, no relationship was found with diastolic blood pressure. Metabolic inflammation and insulin resistance may be in the etiology of systolic HT rather than diastolic HT. Obesity-related hypertension is more common in men, with increasing age, and in those with insulin resistance. Systolic blood pressure may be associated with insulin resistance.

Anahtar Kelimeler

obesity-related hypertension, systolic/diastolic hypertension, insulin resistance, metabolic inflammation

Kaynakça

• Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25 Pt B):2985-3023.
• Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, et al; Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22(Suppl 3):1-203.
• London: National Institute for Health and Care Excellence (NICE Guideline, No. 189.). Obesity: identification, assessment and management [Internet]. 2023 [updated 2023 Jul 26; cited 2024 Jan 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK588750/
• Kosmas CE, Bousvarou MD, Kostara CE, Papakonstantinou EJ, Salamou E, Guzman E. Insulin resistance and cardiovascular disease. J Int Med Res. 2023 Mar;51(3):3000605231164548.
• Wu H, Ballantyne CM. Metabolic inflammation and insulin resistance in obesity. Circ Res. 2020 May 22;126(11):1549-1564.
• Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000 Jul;85(7):2402-10.
• Mancia G, Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, et al. 2023 ESH guidelines for the management of arterial hypertension the Task Force for the management of arterial hypertension of the European Society of Hypertension: endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens. 2023;41:1874-2071.
• Gakidou E. Global, regional, national prevalence of overweight and obesity in children and adults 1980–2013: a systematic analysis. Lancet. 2014;384(9945):766-81.
• Ford ES, Mokdad AH. Epidemiology of obesity in the Western Hemisphere. J Clin Endocrinol Metab. 2008 Nov;93(11 Suppl 1):S1-8.
• Seravalle G, Grassi G. Obesity and hypertension. Pharmacol Res. 2017 Aug;122:1-7.
• Natsis M, Antza C, Doundoulakis I, Stabouli S, Kotsis V. Hypertension in Obesity: Novel Insights. Curr Hypertens Rev. 2020;16(1):30-36.
• Visaria A, Lo D. Association between body mass index and hypertension subtypes in Indian and United States adults. Indian Heart J. 2020 Sep-Oct;72(5):459-461.
• da Silva AA, do Carmo JM, Li X, Wang Z, Mouton AJ, Hall JE. Role of Hyperinsulinemia and Insulin Resistance in Hypertension: Metabolic Syndrome Revisited. Can J Cardiol. 2020 May;36(5):671-682.
• Quesada O, Claggett B, Rodriguez F, Cai J, Moncrieft AE, Garcia K, et al. Associations of Insulin Resistance With Systolic and Diastolic Blood Pressure: A Study From the HCHS/SOL. Hypertension. 2021 Sep;78(3):716-725.
• Wang F, Han L, Hu D. Fasting insulin, insulin resistance and risk of hypertension in the general population: A meta-analysis. Clin Chim Acta. 2017 Jan;464:57-63.
• Ramesh R, Pandurangan V, Madhavan S, Srinivasan D, Bhaskar E, Marappa L, et al. Comparison of Fasting Insulin Level, Homeostatic Model of Insulin Resistance, and Lipid Levels between Patients with Primary Hypertension and Normotensive Subjects. Rambam Maimonides Med J. 2022 Apr 26;13(2):e0009.
• Gu Q, Meng J, Hu X, Ge J, Wang SJ, Liu XZ. Isolated systolic hypertension and insulin resistance assessment tools in young and middle-aged Chinese men with normal fasting glucose: a cross-sectional study. Sci Rep. 2022 Jan 14;12(1):758.
• Ge Q, Qi Z, Xu Z, Li M, Zheng H, Duan X, et al. Comparison of different obesity indices related with hypertension among different sex and age groups in China. Nutr Metab Cardiovasc Dis. 2021 Mar 10;31(3):793-801.
• El-Metwally A, Fatani F, Binhowaimel N, Al Khateeb BF, Al Kadri HM, Alshahrani A, et al. Effect Modification by Age and Gender in the Correlation Between Diabetes Mellitus, Hypertension, and Obesity. J Prim Care Community Health. 2023 Jan-Dec;14:21501319231220234.
• Manios E, Michas F, Stamatelopoulos K, Koroboki E, Stellos K, Tsouma I, et al. Association of isolated systolic, isolated diastolic, and systolic-diastolic masked hypertension with carotid artery intima-media thickness. J Clin Hypertens (Greenwich). 2015 Jan;17(1):22-6.
• Schleh MW, Caslin HL, Garcia JN, Mashayekhi M, Srivastava G, Bradley AB, et al. Metaflammation in obesity and its therapeutic targeting. Sci Transl Med. 2023 Nov 22;15(723):eadf9382.
• Suzuki Y, Kaneko H, Yano Y, Okada A, Matsuoka S, Fujiu K, et al. Reduction in blood pressure for people with isolated diastolic hypertension and cardiovascular outcomes. Eur J Prev Cardiol. 2023 Aug 1;30(10):928-934.