Impact of Metabolically Healthy Obesity on the Development of Hypertension in Normotensive, Nondiabetic Adults : A 4-Year Follow-Up Study

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 677-696-Obesity Physiology & Epidemiology
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-684
Se Eun Park*1, Sang Hoon Han2, Jong Dae Kim1, Won Seon Jeon1, Cheol-Young Park1, Eun-Jung Rhee1, Ki-Won Oh1, Sung-Woo Park1 and Won-Young Lee1
1Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea, 2Yonsei University College of Medicine, Seoul, South Korea
Objective: Recent studies suggest the importance of obese phenotype without the burden of adiposity associated cardiometabolic risk factors in the development of cardiovascular disease. This study aimed to investigate the association between metabolically healthy obesity and future development of hypertension in normotensive, non-diabetic adults.

Methods: We analyzed data from 11,123 adults, aged 20-65 years, who had no history of hypertension or diabetes mellitus at a 2004 medical examination in a health promotion program and had attended a repeat examination in 2008. Being metabolically healthy was defined by having less than 2 components among the five components, that is, high fasting blood glucose, high triglyceride, low high-density lipoprotein cholesterol, highest decile of homeostasis model assessment-insulin resistance (HOMA-IR) index and high-sensitivity C-reactive protein (hs-CRP). Obesity status was assessed by body mass index (BMI) higher than 25 kg/m2. Analyses were performed in 4 groups divided by metabolic health and obesity; metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUHNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUHO).

Results: In four years, 1,142 subjects (10.3%) developed hypertension. 4,954 subjects (44.5 %) were in MHNO group, 2,719 subjects (24.4%) were in MUHNO group, 1,153 subjects (10.4%) were in MHO group, and 2,297 subjects (20.7%) were in MUHO group. The prevalence of hypertension at 4 years showed significant differences: 5.3, 9.3, 15.8 and 19.3% in MHNO, MUHNO, MHO, and MUHO groups. When logistic regression analysis was performed with the development of hypertension as the dependent variable, adjusting for age, sex, smoking status, alcohol consumption, regular exercise, and blood pressure at baseline, MUHNO, MHO, and MUHO groups showed significantly increased risk for hyepertension with odds ratio of 1.59, 2.56 and 3.10 (MHNO group as the reference).

Conclusions: Metabolic health affects the development of hypertension over 4 years more than simple obesity. However, obesity still seems to be a significant risk factor for the development of hypertension. Further study into the physiologic mechanisms underlying these different phenotypes of obesity and their effect on blood pressure is needed.

Nothing to Disclose: SEP, SHH, JDK, WSJ, CYP, EJR, KWO, SWP, WYL

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