title: Low cardiorespiratory fitness levels and elevated blood pressure: what is the contribution of visceral adiposity?
abstract: 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 (r(2)=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 (r(2)=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.
authors.affiliation: Department of Family and Emergency Medicine, Université Laval, Québec, Canada. Caroline.Rheaume@crhl.ulaval.ca
authors.forename: Caroline
authors.initials: C
authors.lastname: Rhéaume
authors.forename: Benoit J
authors.initials: BJ
authors.lastname: Arsenault
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bélanger
authors.forename: Louis
authors.initials: L
authors.lastname: Pérusse
authors.forename: Angelo
authors.initials: A
authors.lastname: Tremblay
authors.forename: Claude
authors.initials: C
authors.lastname: Bouchard
authors.forename: Paul
authors.initials: P
authors.lastname: Poirier
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Després
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002320:Cardiovascular Physiological Phenomena; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000378:metabolism / Q000503:physiopathology; D007328:Insulin / Q000097:blood; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010809:Physical Fitness / Q000502:physiology*; D012044:Regression Analysis; D012143:Respiratory Physiological Phenomena; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007328:Insulin; D008055:Lipids; D002097:C-Reactive Protein