Published online before print January 22, 2008, doi: 10.1161/HYPERTENSIONAHA.107.100255
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(Hypertension. 2008;51:620.)
© 2008 American Heart Association, Inc.
Editorial Commentaries |
Obesity, Insulin Resistance, and Nocturnal Systolic Blood Pressure
From the Department of Physiology (J.R.S.), Department of Internal Medicine (A.W-C., J.R.S.), Diabetes and Cardiovascular Center (A.W-C., J.R.S.), University of Missouri School of Medicine, and Harry S. Truman Veterans’ Affairs Medical Center (A.W-C., J.R.S.), Columbia, Mo.
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
An increasing prevalence of obesity is observed in all age and ethnicity groups and is increasingly being recognized as a serious health problem in children and adolescents.1–4 Obesity is associated with a number of metabolic abnormalities, as well as increased risk for cardiovascular disease (CVD).3,4 In this issue of Hypertension, Lurbe et al5 reported a relationship between insulin resistance, determined by the homeostatic model assessment technique, and nocturnal elevations of systolic blood pressure and heart rate in a large cohort of overweight and obese European children and adolescents. This relationship was present even after adjustment for age, sex, and height. Furthermore, waist circumference was strongly associated with insulin resistance, and both waist circumference and insulin resistance were associated with elevated nocturnal, but not daytime, blood pressures. These are important observations despite some limitations as to the methodology that the investigators used. One limitation of this report is the fact that sleep was not well documented, which limited the ability to strongly relate the nocturnal blood pressures and heart rate to circadian rhythmicity. Another potential limitation of this study relates to the fact that the children were recruited from an obesity clinic; therefore, the data may not be representative of the general population of children and adolescents. Finally, the results of this study are limited by the fact that it was a cross-sectional rather than a prospective longitudinal investigation. Nevertheless, the observations in this study are in concert with previous reports of a positive relationship between insulin resistance and hypertension
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Hypertension 2008 51: 635-641.