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A Journal on Internal Medicine

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Panminerva Medica 1998 March;40(1):22-7

language: English

Many fac­tors can ­affect the prev­a­lence of hyper­ten­sion in obese ­patients: role of ­cuff ­size and ­type of obes­ity

Guagnano M. T., Pace Palitti V., Murri R., Marchione L., Merlitti D., Sensi S.

From the Insti­tute of Inter­nal Med­i­cine Uni­ver­sity of Chie­ti, Chieti, Ita­ly


Objec­tive. To deter­mine to ­what ­extent method­o­log­i­cal ­errors, includ­ing meas­ure­ments tak­en ­with inap­pro­pri­ate ­cuffs and/or inac­cu­ra­cies in ­patient enroll­ment, can con­trib­ute to over­es­ti­mat­ing the prev­a­lence of hyper­ten­sion in over­weight or ­obese wom­en.
Experi­men­tal ­design. Ran­dom­ized and com­par­a­tive inves­ti­ga­tion in over­weight or ­obese out­pa­tient wom­en of the Obes­ity Clin­ic, Inter­nal Med­i­cine Insti­tute, Chie­ti Uni­ver­sity.
­Patients. In 1,791 over­weight or ­obese wom­en, ran­dom­ly select­ed and strat­i­fied by age (41-60 ­years), ­blood pres­sure (BP) was tak­en ­with cas­u­al meas­ure­ment in the morn­ing. The ­entire ­study ­group was divid­ed into two sub­groups. In the ­first one, cas­u­al BP was meas­ured ­with a stan­dard-­size ­cuff (RCS), ­while an appro­pri­ate ­large-­size ­cuff was ­used for the sec­ond one (LCS). ­Patients of the lat­ter sub­group ­were ­also divid­ed by ­type of obes­ity (­android and ­gynoid), ­based on ­their ­waist-to-hip ­ratio.
­Results. In the LCS sub­group, the hyper­ten­sion prev­a­lence ­rate was strik­ing­ly low­er ­among over­weight and ­obese wom­en, as ­well as in the young­er and old­er age ­groups, ­when com­pared ­with the cor­re­spond­ing RCS sub­groups (p<0.001). The hyper­ten­sion prev­a­lence ­rate was high­er for all ­android ­obese sub­jects (53%), includ­ing young­er (34%) and old­er (64%) ­groups, ­when com­pared ­with ­gynoid ­obese ­patients (29%, 18% and 42%, respec­tive­ly).
Con­clu­sions. A com­par­i­son of dif­fer­ent ­reports on the prev­a­lence of hyper­ten­sion in obes­ity ­reveals con­sid­er­able dif­fer­enc­es, due main­ly to age, sex, ­race and ­income lev­el. Nev­er­the­less, our ­data ­seem to indi­cate ­that ­even ­after adjust­ing for the ­above-men­tioned var­i­ables, two sig­nif­i­cant con­found­ing fac­tors, ­cuff hyper­ten­sion and the prev­a­lence of ­android obes­ity in the ­obese ­study pop­u­la­tion, ­could be respon­sible for over­es­ti­mat­ing the prev­a­lence of hyper­ten­sion. It ­should be not­ed ­that for cer­tain ­groups of over­weight and ­obese wom­en, the prev­a­lence of hyper­ten­sion ­becomes sim­i­lar to the ­rate ­found ­among the gen­er­al pop­u­la­tion, as report­ed in ­many ­large epi­dem­i­olog­i­cal sur­veys.

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