Central aortic pulsatile hemodynamics in obese premenopausal women.
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.
Ounis-Skali
Nadia
N
Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Bentley-Lewis
Rhonda
R
Mitchell
Gary F
GF
Solomon
Scott
S
Seely
Ellen W
EW
Hypertension. 2004 Jun;43(6):1239-45
15123572
Hypertension. 2003 Oct;42(4):468-73
12953016
IEEE Trans Biomed Eng. 1988 Jan;35(1):62-8
3338813
Circulation. 2003 Sep 30;108(13):1541-5
14517149
Atherosclerosis. 2006 Jan;184(1):137-42
15913634
Diabetes Care. 1998 Jul;21(7):1178-82
9653616
Circulation. 1983 May;67(5):968-77
6219830
N Engl J Med. 1994 May 19;330(20):1431-8
8159199
J Hypertens. 2005 Oct;23(10):1839-46
16148607
J Physiol. 2000 May 15;525 Pt 1:263-70
10811742
Hypertension. 1999 May;33(5):1111-7
10334796
Circulation. 2004 Nov 2;110(18):2952-67
15509809
Am J Physiol. 1994 Nov;267(5 Pt 2):H1907-15
7977821
Circulation. 2002 Jun 25;105(25):2955-61
12081987
J Appl Physiol (1985). 1997 Jan;82(1):203-10
9029217
J Am Coll Cardiol. 1992 Oct;20(4):952-63
1527307
Int J Obes Relat Metab Disord. 2002 Aug;26(8):1138-43
12119581
Nutr Metab Cardiovasc Dis. 2007 May;17(4):319-26
17110092
Circulation. 1980 Jul;62(1):105-16
7379273
Hypertension. 2001 Dec 1;38(6):1433-9
11751731
Diabetologia. 1985 Jul;28(7):412-9
3899825
Am J Cardiol. 2003 Jan 15;91(2):195-9
12521634
Circulation. 1999 Jul 27;100(4):354-60
10421594