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. 2020 Nov;115(5):896-904.
doi: 10.36660/abc.20190364.

Microvascular Reactivity in Hypertensive Patients with High Body Adiposity

[Article in English, Portuguese]
Jenifer d'El-Rei  1 , Michelle Rabello Cunha  1 , Samanta de Souza Mattos  1 , Bianca Cristina Marques  1 , Viviane Prangiel de Menezes  1 , Ana Rosa Cunha  1 , Érica Monteiro França  1 , Wille Oigman  1 , Mario Fritsch Neves  1
Affiliations

Microvascular Reactivity in Hypertensive Patients with High Body Adiposity

[Article in English, Portuguese]
Jenifer d'El-Rei et al. Arq Bras Cardiol. 2020 Nov.

Abstract
in English, Portuguese

Background: Several anthropometric indexes have been proposed to determine the association between overweight and cardiovascular risk factors.

Objective: To evaluate the relationship between body adiposity and microvascular reactivity in hypertensive patients under antihypertensive therapy.

Methods: Treated hypertensive patients aged 40 to 70 were submitted to evaluation of anthropometric indexes: conicity (CI), body adiposity (BAI), visceral adiposity (VAI) and waist-to-height ratio (WHtR). Participants were divided by the terciles of fat percentage (%F) obtained by bioelectrical impedance. The patients underwent microvascular reactivity test (Laser Speckle Contrast Image) and pulse wave velocity (PWV) measurement. The p value <0.05 was considered statistically significant.

Results: The variation of the area under the curve (AUC) of the skin perfusion was lower in the upper tercile (97±57% vs. 67±36%; p=0.027). %F showed significant correlation with WHtR (r=0.77; p<0.001), VAI (r=0.41; p=0.018), CI (r=0.60; p<0.001), BAI (r=0.65; p<0.001) in men and only with WHtR (r=0.55; p<0.001) and BAI (r=0.60; p<0.001) in women. In linear regression, AUC was independently associated with %F (β=-3.15; p=0.04) in women and with blood glucose (β=-1.15; p=0.02) in men. There was no difference in PWV measurements.

Conclusion: Anthropometric indices were more associated with %F in men. Higher body adiposity was associated with lower microvascular reactivity, which was more evident in women. There was no difference in arterial stiffness, which may have been influenced by antihypertensive treatment.

Fundamento: Diversos índices antropométricos têm sido propostos para determinar a associação entre excesso de peso e fatores de risco cardiovascular.

Objetivo: Avaliar a relação entre adiposidade corporal e reatividade microvascular em pacientes hipertensos sob terapia anti-hipertensiva.

Métodos: Pacientes hipertensos tratados de 40 a 70 anos foram submetidos à avaliação de índices antropométricos: conicidade (IC), adiposidade corporal (IAC), adiposidade visceral (IAV) e relação cintura-estatura (RCE). Os participantes foram divididos pelos tercis de percentual de gordura (%G) obtido pela bioimpedância elétrica (BIA) e submetidos a teste de reatividade microvascular (laser speckle contrast image), medida da velocidade da onda de pulso (VOP). O valor de p < 0,05 foi considerado estatisticamente significativo.

Resultados: A variação da área sob a curva (ASC) da perfusão cutânea foi inferior no tercil superior (97 ± 57% vs. 67 ± 36%; p = 0,027). O %G apresentou correlação significativa com RCE (r = 0,77; p < 0,001), IAV (r = 0,41; p = 0,018), IC (r = 0,60; p < 0,001) e IAC (r = 0,65; p < 0,001) nos homens e somente com RCE (r = 0,55; p < 0,001) e IAC (r = 0,60; p < 0,001) nas mulheres. Na regressão linear, a ASC mostrou associação independente com o %G (β =–3,15; p = 0,04) nas mulheres e com a glicemia (β = –1,15; p = 0,02) nos homens. Não houve diferença nas medidas de VOP.

Conclusão: Os índices antropométricos de obesidade foram mais associados ao %G nos homens. A maior adiposidade corporal foi relacionada com menor reatividade microvascular, o que foi mais evidente nas mulheres. Não houve diferença na rigidez arterial, o que pode ter sido influenciado pelo tratamento anti-hipertensivo.

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Conflict of interest statement

Potencial conflito de interesses

Declaro não haver conflito de interesses pertinentes.

Figures

Figura 1
Figura 1. Correlação da variação da área sob a curva da perfusão cutânea pelo método laser speckle contrast image com gordura corporal em mulheres e com glicemia em homens.
Figure 1
Figure 1. Correlation of the change in the area under the curve of skin perfusion by the laser speckle contrast imaging method with body fat in women and with glycemia in
See this image and copyright information in PMC

Comment in

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