title: Regional Fat Distribution and Blood Pressure Level and Variability: The Dallas Heart Study.
abstract: Our aim was to investigate the associations of regional fat distribution with home and office blood pressure (BP) levels and variability. Participants in the Dallas Heart Study, a multiethnic cohort, underwent 5 BP measurements on 3 occasions during 5 months (2 in home and 1 in office) and quantification of visceral adipose tissue, abdominal subcutaneous adipose tissue, and liver fat by magnetic resonance imaging, and lower body subcutaneous fat by dual x-ray absorptiometry. The relation of regional adiposity with short-term (within-visit) and long-term (overall visits) mean BP and average real variability was assessed with multivariable linear regression. We have included 2595 participants with a mean age of 44 years (54% women; 48% black), and mean body mass index was 29 kg/m(2) Mean systolic BP/diastolic BP was 127/79 mm Hg and average real variability systolic BP was 9.8 mm Hg during 3 visits. In multivariable-adjusted models, higher amount of visceral adipose tissue was associated with higher short-term (both home and office) and long-term mean systolic BP (β[SE]: 1.9[0.5], 2.7[0.5], and 2.1[0.5], respectively; all P<0.001) and with lower long-term average real variability systolic BP (β[SE]: -0.5[0.2]; P<0.05). In contrast, lower body fat was associated with lower short-term home and long-term mean BP (β[SE]: -0.30[0.13] and -0.24[0.1], respectively; both P<0.05). Neither subcutaneous adipose tissue or liver fat was associated with BP levels or variability. In conclusion, excess visceral fat was associated with persistently higher short- and long-term mean BP levels and with lower long-term BP variability, whereas lower body fat was associated with lower short- and long-term mean BP. Persistently elevated BP, coupled with lower variability, may partially explain increased risk for cardiac hypertrophy and failure related to visceral adiposity.
authors.affiliation: From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., M.R.C., P.G.); Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (W.V., A.T., A.C., J.A.d.L., I.J.N.); Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas (C.A.).
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yano
authors.affiliation: From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., M.R.C., P.G.); Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (W.V., A.T., A.C., J.A.d.L., I.J.N.); Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas (C.A.).
authors.forename: Wanpen
authors.initials: W
authors.lastname: Vongpatanasin
authors.affiliation: From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., M.R.C., P.G.); Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (W.V., A.T., A.C., J.A.d.L., I.J.N.); Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas (C.A.).
authors.forename: Colby
authors.initials: C
authors.lastname: Ayers
authors.affiliation: From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., M.R.C., P.G.); Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (W.V., A.T., A.C., J.A.d.L., I.J.N.); Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas (C.A.).
authors.forename: Aslan
authors.initials: A
authors.lastname: Turer
authors.affiliation: From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., M.R.C., P.G.); Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (W.V., A.T., A.C., J.A.d.L., I.J.N.); Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas (C.A.).
authors.forename: Alvin
authors.initials: A
authors.lastname: Chandra
authors.affiliation: From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., M.R.C., P.G.); Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (W.V., A.T., A.C., J.A.d.L., I.J.N.); Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas (C.A.).
authors.forename: Mercedes R
authors.initials: MR
authors.lastname: Carnethon
authors.affiliation: From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., M.R.C., P.G.); Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (W.V., A.T., A.C., J.A.d.L., I.J.N.); Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas (C.A.).
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
authors.affiliation: From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., M.R.C., P.G.); Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (W.V., A.T., A.C., J.A.d.L., I.J.N.); Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas (C.A.).
authors.forename: James A
authors.initials: JA
authors.lastname: de Lemos
authors.affiliation: From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., M.R.C., P.G.); Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (W.V., A.T., A.C., J.A.d.L., I.J.N.); Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas (C.A.). ian.neeland@utsouthwestern.edu.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Neeland
mesh_terms: D000328:Adult; D000367:Age Factors; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D050218:Body Fat Distribution / Q000009:adverse effects*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000503:physiopathology; D015331:Cohort Studies; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D050152:Intra-Abdominal Fat / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology; D011379:Prognosis; D018570:Risk Assessment; D012737:Sex Factors; D050151:Subcutaneous Fat / Q000503:physiopathology; D013781:Texas
keywords: adipokine; adiponectin blood pressure hypertension intra-abdominal fat obesity visceral adipose tissue