Correlation Of The Abdominal Obesity And Circadian Blood Pressure Rhythms With Arterial Stiffness In Elderly Women

Background:Along with the improvement of the living stations of our country, there was a great changing in people’s lifestyle and diet structure. More fat in daily diet and lack of exercise had made a rapid rise in obesity rates in both urban and rural. Obesity can be divided into the abdominal obesity and non-abdominal obesity, based on the waistline. Studies confirm that obesity is closely related to the occurrence of varieties of metabolic diseases. Obesity is an independent risk factor for high blood pressure, diabetes, lipid metabolic disorder and atherosclerosis and other chronic diseases. And abdominal obesity can significantly increase the risk of hypertension, diabetes and metabolic syndrome. With the increase of age, due to the changes of physiology and metabolism, overweight and obesity rates increase. After 45 years old, the rate of overweight and obesity in female is equal to or even greater than the male. After menopause, hypertension, hyperlipidemia, coronary heart disease (CHD) and the prevalence of atherosclerosis and other cardiovascular disease is much higher than premenopausal, risk start is even higher than men. However, clinical trials conducted for elderly women is still relatively small, a lot of treatments, diagnosis and prevention programs are still controversial.Object:1) To investigate the correlation of the abdominal obesity and circadian blood pressure rhythms with arterial stiffness in elderly women.2) Explore the impact of abdominal obesity and non dipper type blood pressure to arteries, and the interaction of them.Methods:Data were extracted from 353 eligible elderly women. According to waist circumference, all participants were divided into two groups, namely, non-abdominal obesity group (160 cases), abdominal obesity group (193 cases). In this study, body mass index (BMI) is not involved in the definition of abdominal obesity. All participant were divided into dipper blood pressure group (166 cases) and non-dipper blood pressure group (187 cases), in the station of circadian rhythm of blood pressure. Also all participant were divided into four groups by the waist and blood pressure rhythm combined station, normal waist+dipper group (n= 108), waist increased+dipper group (w=79), non-dipper+normal waist group (n=52) and non-dipper+increased waistline group (n=114). We measured the height, body weight, waistline, and blood lipids, blood sugar with other biochemical indicators of all participates. Ambulatory blood pressure and carotid-radial pulse wave velocity (crPWV) were observed in participant. According to the average rate of nocturnal blood pressure dropped, the participants are divided into dipper and non-dipper blood pressure blood pressure, and in accordance with the formula to calculate the dynamic symmetrically atherogenic index (sym-AASI).Results:1) systolic blood pressure decrease rate of abdominal obesity group (12.87±7.62%) were higer than the abdominal obesity group (9.05±6.78%), the difference was statistically significant (P<0.01). Nocturnal diastolic blood pressure decrease rate of abdominal obesity group (12.54±7.19%) is greater than the abdominal obesity group (8.34±6.39%), the difference was statistically significant (P<0.01). The mane of nighttime blood pressure drops rate of abdominal obesity group (12.65±5.31%) is greater than the abdominal obesity group (8.58±4.96%), the difference was statistically significant (P<0.01).The 24 h systolic blood pressure of abdominal obesity group (135.49±11.98 mm Hg) is less than the abdominal obesity group (138.20±12.45 mm Hg), the difference was statistically significant (P<0.05). The 24 h diastolic blood pressure of abdominal obesity group (77.97± 8.46 mm Hg) is less than the abdominal obesity group (81.06±8.15 mm Hg), the difference was statistically significant (P< 0.01).The daytime systolic blood pressure of abdominal obesity group (141.58±12.15 mm Hg) is less than the abdominal obesity group (142.50±12.42 mm Hg), the difference was statistically significant (P< 0.05). Daytime diastolic blood pressure of abdominal obesity group (81.34±8.28 mm Hg) is less than the abdominal obesity group (83.37±8.17 mm Hg), the difference was statistically significant (P < 0.01). The nighttime systolic blood pressure of abdominal obesity group (123.31±14.70 mm Hg) is less than abdominal obesity group (129.60±14.84 mm Hg), the difference was statistically significant (P< 0.01).The nocturnal diastolic blood pressure of abdominal obesity group (71.22±10.03 mm Hg) is less than the abdominal obesity group (76.43±9.22 mm Hg), the difference was statistically significant (P<0.01); Dynamic blood pressure of hypertension incidence of abdominal obesity group [113(70.6%)] is less than the abdominal obesity group [155(80.3%)], the difference was statistically significant (z=4.489, P< 0.05).2)The crPWV(11.78±1.18 m/s)、 sym-AAS (0.31±0.15) of abdominal obesity group is significantly higher than non-abdominal obesity group, (10.85±1.04 m/s) and (0.23± 0.17),the difference is statistically significant (P<0.05).3) The waist was associated with crPWV, sym-AASI (r=0.387,0.538, P< 0.05).4) The waist of non-dipper group (85.09±8.36 cm) was higher than dipper group (80.73 ±7.95 cm), the difference was statistically significant (P<0.05).5) The crPWV(11.57±1.25 m/s), sym-AASI (0.28+0.16) of non-dipper group was higher than dipper group(11.17±1.14 m/s) and (0.27+0.16), the difference was statistically significant (P< 0.05).6) The nighttime blood pressure dropped mean rate was associated with crPWV, sym-AASI(r=-0.29、-0.29, P< 0.05).7) CrPWV, and sym-AASI have differences between different type blood pressure rhythm of different obesity group. CrPWV in dipper+normal waist group (10.78±0.98 m/s) is below dipper+high waist group (11.69±1.14 m/s) and non dipper+normal waistline group (11.00±1.15 m/s) and non dipper+increased waist group (11.83±1.21 m/s), CrPWV in dipper+waist increased group (11.69±1.14 m/s) is lower than that of non dipper+normal waistline group (11.00±1.15 m/s) and non dipper + waist increased group (11.83±1.21 m/s). CrPWV in non dipper+normal waistline group (11.00±1.15 m/s) is lower than that of non dipper+increased waist group (11.83±1.21 m/s), a vision was statistically significant (P< 0.05).CrPWV different type blood pressure rhythm of different obesity group, there are differences between the sym-AASI:scoop type+normal waist crPWV (10.78±0.98 m/s) below scoop type+group increased waist circumference(11.69±1.14 m/s), non dipper type +waistline normal group (11.00±1.15 m/s) group, non dipper type+increased waist circumference (11.83±1.21 m/s), scoop type crPWV+increased waist circumference group (11.69±1.14 m/s) lower than that of non dipper type+waistline normal group (11.00±1.15 m/s) group and non dipper type+ increased waist circumference (11.83±1.21 m/s), non dipper type+waistline crPWV normal group (11.00±1.15 m/s) lower than that of non dipper +group increased waist circumference (11.83±1.21 m/s), a vision was statistically significant (P< 0.05).The sym-AASI in dipper+normal waist group (0.21±0.16) is lower than the dipper+ waist increased group (0.31±0.15) and non dipper+normaLwaistline group (0.22±0.19) and non dipper+waist increased group (0.32±0.14). The sym-AASI in dipper+waist increased group (0.31±0.15)is lower than that of non dipper+normal waistline group (0.22±0.19) and non dipper type+waist increased group (0.32±0.14). The sym-AASI of non dipper+ normal waistline group (0.22±0.19) is lower than that of non dipper+waist increased group (0.32±0.14), a vision was statistically significant (P< 0.05).8) The 2×2 two-factor factorial analysis of waist circumference and blood pressure rhythm on crPWV show that the crPWV of abdominal obesity group compared with the non-abdominal obesity group (regardless of blood pressure circadian rhythm) increased 0.87 (m/s), and the crPWV of non dipper group compared with dipper group (regardless of the abdominal obesity) increased 0.25 (m/s). The interaction of abdominal obesity and the dipper type blood pressure on crPWV has increased 0.01 (m/s), and straight lines of the interaction effect are almost parallel, and synergistic effect of the two factor are small. The 2×2 two-factor factorial analysis of waist circumference and blood pressure rhythm on sym-AASI show that the crPWV of abdominal obesity group compared with the non-abdominal obesity group (regardless of blood pressure circadian rhythm) increased 0.01, and the sym-AASI of non dipper group compared with dipper group (regardless of the abdominal obesity) increased 0.02. The interaction of abdominal obesity and the dipper type blood pressure on sym-AASI has increased 0.01, and straight lines of the interaction effect are almost parallel, and synergjstic effect of the two factor are small. Conclusion:1. Abdominal obesity is closely related to the disappearance of the normal blood pressure rhythm in elderly women.2. The increase of abdominal obesity rates is closely related to arteriosclerosis in elderly women.3. The increase of non dipper rates is closely related to arteriosclerosis in elderly women.4. The increase of abdominal obesity rates and non dipper rates is interacted with arteriosclerosis in elderly women.