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(Hypertension. 2009;54:91.)
© 2009 American Heart Association, Inc.

Original Articles

Low Cardiorespiratory Fitness Levels and Elevated Blood Pressure

What Is the Contribution of Visceral Adiposity?

Caroline Rhéaume; Benoit J. Arsenault; Stéphane Bélanger; Louis Pérusse; Angelo Tremblay; Claude Bouchard; Paul Poirier; Jean-Pierre Després

From the Department of Family and Emergency Medicine, Faculty of Medicine (C.R., S.B.), Division of Kinesiology, Department of Social and Preventive Medicine (L.P., A.T., J-P.D.), and Faculty of Pharmacy (P.P.), Université Laval, Québec, Canada; Institut Universitaire de Cardiologie et de Pneumologie de Québec (C.R., B.J.A., S.B., A.T., P.P., J-P.D.), Québec, Canada; and Pennington Biomedical Research Center (C.B.), Baton Rouge, La.

Correspondence to Caroline Rhéaume, Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725 Chemin Ste-Foy, Pavilion Marguerite-D’Youville, 2nd Floor, Québec, Canada G1V 4G5. E-mail Caroline.Rheaume{at}crhl.ulaval.ca

Individuals with poor cardiorespiratory fitness have higher blood pressure than fit individuals. Individuals with low fitness levels also tend to be characterized by higher visceral adiposity compared with physically fit individuals. We tested the hypothesis that the relationship between low fitness and elevated blood pressure could be related, at least in part, to the higher level of visceral adipose tissue often found among unfit individuals. This study included 407 asymptomatic, nondiabetic participants. Visceral adipose tissue was assessed by computed tomography, and fitness was measured by a progressive submaximal physical working capacity test. Participants in the highest visceral adipose tissue tertile showed the highest systolic and diastolic blood pressures, whereas participants in the highest fitness tertile had the lowest blood pressure values (P<0.001). When participants were classified into fitness tertiles and then subdivided on the basis of visceral adipose tissue (high versus low), participants with a high visceral adipose tissue had higher systolic and diastolic blood pressure values (P=0.01), independent of their fitness category. Linear regression analyses showed that age and visceral adipose tissue, but not fitness, predicted systolic blood pressure (r²=0.11 [P<0.001], 0.12 [P<0.001], and 0.01 [P value nonsignificant], for age, visceral adipose tissue, and fitness, respectively) and diastolic blood pressure (r²=0.17 [P<0.001], 0.14 [P<0.001], and 0.01 [P value nonsignificant], for age, visceral adipose tissue, and fitness, respectively). Individuals with high visceral adipose tissue levels have higher blood pressure, independent of their fitness. Visceral adipose tissue may represent an important clinical target in the management of elevated blood pressure.

Key Words: cardiorespiratory fitness • systolic and diastolic blood pressures • visceral adipose tissue • body mass index