Relationship Between Abdominal Fat And Ambulatory Blood Pressure Monitoring

The incidence rate of hypertension has been rapidly increasing in the past decades in our country,which is 18.8%nowadays,while the population are over one hundred sixty million.The incidence rate of obesity in adult is 7.7%and the rate of gravitas over-weight is 22.8%.People who suffered from obesity or gravitas are approaching to sixty millions and two hundred millions.Obesity and hypertension are often clustered in the same patient. Some study showed that waist circumference(WC) as well as body mass index(BMI) is in good correlationship with blood pressure.It is easy to infer that the increase of hypertensin incidence may partly be due to the increase of obesity,especially the abdomenial obesity. Its primary feature is the accumulation of visceral adipose tissue in abdomen.Past researches paid much attention to the relationship between BMI or WC and causal blood pressure.However,the former is mainly characterised by visceral fat tissue acumlation. And ABPM is better than casual blood pressure as a parameter in reflecting state of hypertension.The relationship between abdominal adipose tissue and ABPM is rarely reported.This study aims to investigate the distribution of abdominal adipose tissue in subjects and its effect on ABPM to provide an opportunity to prevent or delay hypertension in patients with obesity.Subjects and Methods1.SubjectsOne hundred and seventeen patients aged 32 to 78 years old(male 60 and female 57) were divided into three groups according to the patient with hypertension and obesity or without.1)NH;2)HT;3)HT+ob,according to hypertension and obesity or not.The standard of obesity diagnosis could be divided into the following four parts:BMI was noted by "Classification suggestions of BMI of Chinese adults" promoted by working group of obesity of China in year 2001.(the obesity of adult which was categorizaed by the group of the problem of obesity in China in 2001,);WC was diagnosed by modified IDF criteria of 2005;WHR was diagnosed according to WHO;VA was diagnosed by abdominal adipose tissue equal to or over 100cm2,.MS was diagnosed by modified IDF criteria of 2005. Hypertension was identified according to the criteria of guide which was decided by prevention and cure of hypertension of China in 2005.DMwas defined according to the criteria of ADA in 1997.Those who had serious impairment of hepatic or nephritic renal function and those whose cardiac function were over gradeⅢwere excluded.2.MethodsVenous blood were collected to assay fasting plasma glucose(FPG),fasting insulin(FIN),fasting total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-c),low density lipoprotein cholesterol(LDL-c),urea nitrogen(BUN) and creatinine(Cr).Urinary albumin excretion(UAE) and urinary creatinine were detected and creatinine clearance value rate were calculated by computer.Some subjects run oral glucose tolerance test and insulin releasing test.All patients were surveyed blood pressure, height,body weight and waist circumference(WC),then BMI and WHR were calculated. All patients were observed to measure the visceral adipose tissue area(VA).ABPM were recorded,including SBP and DBP of daytime as well as nightime and 24h.Color Doppler echocardiography were used to assess cardiac feature,including left ventricular inner diameter of diastole period end point,left ventricular posterior wall thickness(LVPW) and interventricular septum thickness(IVS).Left ventricular mass(LVM) and left ventricular mass index(LVMI) were calculated according to Dereveux formula.Results1.When VA≥100cm~2,dSBP only was positively enhanced as VA increased(P＜0.05).2.When VA≥100cm~2,MAU increased as VA heightened(P＜0.05).3.When VA≥100cm~2,VA was significantly correlated positively with IVS and LVM (P＜0.05).Conclusions1.After the relationship between BMI,WC,WHR,VA and AMBP are analysised,It be comes obvious that visceral fat tissue contributes a lot to systolic blood pressure increase,fr ee of interference from hypotensive agents.2.As visceral fat tissue enlarged,the early damage of kidney as well as cardiac remode ling of hypertension patients who are complicated with central obesity becomes more signif icant.3.From the analysis above,we can draw a conclusion that suppression of visceral fat ti ssue accumulation is valuable for hypertension control and reduction of target organs dama ge to those who are suffering from hypertension and central obesity,except for controlling blood pressure.