Obesity and Hypertension in Association with Diastolic Dysfunction Could Reduce Exercise Capacity.
OBJECTIVE
Empirical evidence is lacking on the cumulative disease burden of obesity and hypertension and its impact on cardiac function and exercise capacity. The purpose of this study was to determine whether the presence of obesity and hypertension together was associated with cardiac dysfunction and exercise capacity.


METHODS
Using a retrospective study design, medical records were reviewed for echocardiographic and treadmill exercise stress test data. Subjects were grouped according to four categories: normal control, obese, hypertensive, or obese and hypertensive.


RESULTS
Obese, hypertensive persons showed significantly lower Ea and E/A ratio and greater E/Ea ratio, deceleration time, left ventricular (LV) mass, and LV mass index compared to their counter parts (normal control, obese and/or hypertensive) (all p<0.05), after controlling for age and sex. After controlling for age and sex, significant differences in exercise capacity indices were found, with the obese group having shorter exercise time, lower metabolic equivalents, and lower maximal oxygen uptake than the normal control, hypertensive, or both groups (all p<0.05). The hypertensive or obese and hypertensive group had greater maximal blood pressure compared with the normal control group (all p<0.001). Obese and hypertensive persons were approximately three times more likely to have diastolic dysfunction (odd ratio=2.96, p=0.001), when compared to the reference group (normotensive, non-obese, or hypertensive only persons).


CONCLUSIONS
Diastolic dysfunction was associated with obesity and/or hypertension. The cumulative risk of obesity and hypertension and their impact on diastolic dysfunction which could be modifiable could reduce exercise capacity.
Gachon University College of Nursing, Incheon, Korea .
JinShil
J
Kim
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea .
Myeong Gun
MG
Kim
Dongseoi University College of Nursing, Pusan, Korea .
SeWon
S
Kang
Department of Internal Medicine, Seoul Medical Center, Seoul, Korea .
Bong Roung
BR
Kim
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea .
Min Young
MY
Baek
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.; Gachon University College of Medicine, Incheon, Korea.
Yae Min
YM
Park
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.; Gachon University College of Medicine, Incheon, Korea.
Mi-Seung
MS
Shin
Diastolic function; Echocardiography; Exercise capacity; Hypertension; Obesity