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

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

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


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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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