title: Central aortic pulsatile hemodynamics in obese premenopausal women.
abstract: Obesity is a known risk factor for cardiovascular disease (CVD) but the mechanism by which obesity contributes to cardiovascular risk is not well understood. Arterial stiffness is a CVD risk factor associated with obesity. We studied 16 obese body mass index (BMI > 30) and 10 lean (BMI < 25) healthy premenopausal women. We measured fasting glucose, insulin, and lipids, blood pressure, and arterial tonometry to assess arterial stiffness. Obese women had higher glucose, insulin, total cholesterol and triglyceride levels, blood pressures, cardiac output, and peak flow. Characteristic impedance was lower (146 +/- 31 [(dyne . s) . cm(-5)] vs. 187 +/- 48 [(dyne . s) . cm(-5)]; P = .01), aortic diameter was greater (2.54 +/- 0.20 cm vs. 2.29 +/- 0.21 cm; P < .01), and peripheral pulse pressure was similar in obese compared with lean women. Obesity in premenopausal women is associated with increased cardiac output and peak aortic flow. Increased aortic diameter in obese women was associated with reduced characteristic impedance, potentially preventing an increase in peripheral pulse pressure despite elevated flow, which suggests proximal aortic remodeling. When aortic remodeling and compensation for increased hemodynamic demands are limited by environmental or genetic interference, hypertension or CVD may result.
authors.affiliation: Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Nadia
authors.initials: N
authors.lastname: Ounis-Skali
authors.forename: Rhonda
authors.initials: R
authors.lastname: Bentley-Lewis
authors.forename: Gary F
authors.initials: GF
authors.lastname: Mitchell
authors.forename: Scott
authors.initials: S
authors.lastname: Solomon
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Seely
references.citation: Hypertension. 2004 Jun;43(6):1239-45
references.pmid: 15123572
references.citation: Hypertension. 2003 Oct;42(4):468-73
references.pmid: 12953016
references.citation: IEEE Trans Biomed Eng. 1988 Jan;35(1):62-8
references.pmid: 3338813
references.citation: Circulation. 2003 Sep 30;108(13):1541-5
references.pmid: 14517149
references.citation: Atherosclerosis. 2006 Jan;184(1):137-42
references.pmid: 15913634
references.citation: Diabetes Care. 1998 Jul;21(7):1178-82
references.pmid: 9653616
references.citation: Circulation. 1983 May;67(5):968-77
references.pmid: 6219830
references.citation: N Engl J Med. 1994 May 19;330(20):1431-8
references.pmid: 8159199
references.citation: J Hypertens. 2005 Oct;23(10):1839-46
references.pmid: 16148607
references.citation: J Physiol. 2000 May 15;525 Pt 1:263-70
references.pmid: 10811742
references.citation: Hypertension. 1999 May;33(5):1111-7
references.pmid: 10334796
references.citation: Circulation. 2004 Nov 2;110(18):2952-67
references.pmid: 15509809
references.citation: Am J Physiol. 1994 Nov;267(5 Pt 2):H1907-15
references.pmid: 7977821
references.citation: Circulation. 2002 Jun 25;105(25):2955-61
references.pmid: 12081987
references.citation: J Appl Physiol (1985). 1997 Jan;82(1):203-10
references.pmid: 9029217
references.citation: J Am Coll Cardiol. 1992 Oct;20(4):952-63
references.pmid: 1527307
references.citation: Int J Obes Relat Metab Disord. 2002 Aug;26(8):1138-43
references.pmid: 12119581
references.citation: Nutr Metab Cardiovasc Dis. 2007 May;17(4):319-26
references.pmid: 17110092
references.citation: Circulation. 1980 Jul;62(1):105-16
references.pmid: 7379273
references.citation: Hypertension. 2001 Dec 1;38(6):1433-9
references.pmid: 11751731
references.citation: Diabetologia. 1985 Jul;28(7):412-9
references.pmid: 3899825
references.citation: Am J Cardiol. 2003 Jan 15;91(2):195-9
references.pmid: 12521634
references.citation: Circulation. 1999 Jul 27;100(4):354-60
references.pmid: 10421594