title: The impact of body mass index on pulse pressure in obesity.
abstract: OBJECTIVE
  Pulse pressure, a marker of arterial vascular properties, has been linked to cardiovascular diseases and complications. This study examined the impact of excess body mass and cardiovascular disease risk factors on pulse pressure (PP).
  
  
  METHODS
  Cross-sectional and prospective study.
  
  
  METHODS
  Baseline data consist of 219 obese African Americans, with mean +/- SD age of 46.8 +/- 10.9 years enrolled in a diet and exercise program of weight reduction. A non-invasive monitoring device was used to acquire 24 hourly ambulatory blood pressures. Pulse pressure was calculated as the difference between the average 24-h systolic and diastolic blood pressure and studied as a continuous variable and according to quartiles. The cross-sectional association of pulse pressure with body mass index (BMI) was examined using multivariate linear regression and proportional odds models that controlled for cardiovascular disease risk factors. In addition, we examined prospectively, in 36 participants, the effect of weight loss on pulse pressure, using the Wilcoxon signed ranked test.
  
  
  RESULTS
  At baseline, a 5 kg/m2 increase in BMI was independently associated with a 35% risk [relative risk (RR) = 1.35, confidence interval (CI) = 1.10-1.65, P < 0.01] in the general study population and 19% (RR = 1.19, CI = 1.07-1.56, P = 0.04) in obese normotensives for increasing PP by one quartile after adjustment for other significant variables. After 3 months of diet and exercise intervention, BMI decreased by an average of 10.6% (P < 0.01) and resulted in an 8.8% (P < 0.01) reduction in PP.
  
  
  CONCLUSIONS
  In the context of obesity, increasing BMI is independently associated with decreasing arterial compliance, as reflected in PP. This association highlights the potential value to cardiovascular health of any reduction in body weight in obese individuals.
authors.affiliation: General Clinical Research Center, Howard University College of Medicine, NW, Washington, DC 20060, USA.
authors.forename: John
authors.initials: J
authors.lastname: Kwagyan
authors.forename: Cyril E
authors.initials: CE
authors.lastname: Tabe
authors.forename: Shichen
authors.initials: S
authors.lastname: Xu
authors.forename: Abid R
authors.initials: AR
authors.lastname: Maqbool
authors.forename: Victor R
authors.initials: VR
authors.lastname: Gordeuk
authors.forename: Otelio S
authors.initials: OS
authors.lastname: Randall
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001794:Blood Pressure; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior