Published Online
on February 21, 2005

A more recent version of this article appeared on April 1, 2005

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Submitted on September 9, 2004
Revised on October 1, 2004

Impact of Obesity on 24-Hour Ambulatory Blood Pressure and Hypertension

Vasilios Kotsis^*; Stella Stabouli; Marshall Bouldin; Annette Low; Savvas Toumanidis; and Nikos Zakopoulos

From the Department of Clinical Therapeutics (V.K., S.S., S.T., N.Z.), Alexandra Hospital, National and Kapodestrial University, Athens, Greece; the Department of Physiology and Biophysics and Center of Excellence in Cardiovascular-Renal Research (V.K.) and the Department of Medicine (V.K., S.S., M.B., A.L.), Metabolic Disorders Clinic, the University of Mississippi Medical Center, Jackson, Miss.

^* To whom correspondence should be addressed. E-mail: vkotsis{at}physiology.umsmed.edu.

Abstract--The purpose of the present study was to determine the relationship between body mass index (BMI) and parameters derived from 24-hour ambulatory blood pressure monitoring including mean 24-hour daytime and nighttime systolic and diastolic blood pressures, 24-hour daytime and nighttime pulse pressure, mean 24-hour daytime and nighttime heart rate, dipping and nondipping status. 3216 outpatient subjects who visited our hypertension center and were never treated with antihypertensive medication underwent 24-hour blood pressure monitoring. BMI was significantly correlated with clinic systolic and diastolic blood pressures. Significant correlations were also found between BMI and mean 24-hour daytime and nighttime systolic blood pressure, 24-hour daytime and nighttime pulse pressure, and mean 24-hour daytime and nighttime heart rate. In multivariate regression analysis, clinic systolic, diastolic blood pressure, mean 24-hour systolic blood pressure, 24-hour pulse pressure, and high-density lipoprotein were independently correlated with BMI. The incidence of white coat hypertension was higher in overweight and obese patients than in normal weight subjects. Confirmed ambulatory blood pressure hypertension was also found to be higher in overweight and obese individuals compared with normal weight subjects. Our data also highlight the higher incidence of nondipping status in obesity. These findings suggest that obese patients had increased ambulatory blood pressure parameters and altered circadian blood pressure rhythm with increased prevalence of nondipping status.

Key words: blood pressure monitoring, ambulatory • body mass index • hypertension • obesity

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