Predictors of Cardiac Autonomic Dysfunction in Obesity-Related Hypertension.

IF 3.1 Q2 PERIPHERAL VASCULAR DISEASE High Blood Pressure & Cardiovascular Prevention Pub Date : 2024-01-01 Epub Date: 2024-02-12 DOI:10.1007/s40292-024-00623-7
Aqsa Mujaddadi, Saima Zaki, Majumi M Noohu, Irshad Husain Naqvi, Zubia Veqar
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Abstract

Introduction: Cardiac Autonomic Dysfunction (CAD) is an overlooked cardiovascular risk factor in individuals with obesity-related hypertension. Despite its clinical significance, there is a notable lack of clarity regarding the pathophysiological correlates involved in its onset and progression.

Aim: The present study aimed to identify potential predictors of CAD in obesity-related hypertension.

Methods: A total of 72 participants (34 men and 38 women) were enrolled. Comprehensive evaluations were conducted, including cardiac autonomic function assessments, body composition estimation and biochemical analysis. Participants were categorized as CAD-positive or CAD-negative based on Ewing's criteria for autonomic dysfunction. Univariate logistic regression analysis was performed to identify potential predictors for CAD. Multivariate logistic regression models were further constructed by adjusting clinically relevant covariates to identify independent predictors of CAD.

Results: Multivariate logistic regression analysis revealed that resting heart rate (HRrest), (odds ratio, confidence interval: 0.85, 0.78-0.93; p = 0.001) and percentage body fat (BF%), (odds ratio, confidence interval: 0.78, 0.64-0.96; p = 0.018) were significant independent predictors of CAD. Receiver Operating Characteristic curve analysis depicted optimal cut-off values for HRrest and BF% as > 74.1 bpm and > 33.6%, respectively. Multicolinearity analysis showed variance inflation factors (VIF) below the cautionary threshold of 3.

Conclusions: The HRrest and BF% emerged as significant independent predictors of CAD in obesity-related hypertension. Therapeutic strategies should target HRrest < 74.1 bpm and BF% < 33.6% to mitigate CAD risk in this population. Future trials are required to establish causal relationships and may consider additional confounding variables in obesity-related hypertension.

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肥胖相关高血压患者心脏自主神经功能障碍的预测因素
导言:心脏自主神经功能障碍(CAD)是肥胖相关性高血压患者中一个被忽视的心血管风险因素。目的:本研究旨在确定肥胖相关性高血压患者心血管自主神经功能障碍的潜在预测因素:方法:共招募了 72 名参与者(34 名男性和 38 名女性)。方法:共招募了 72 名参与者(34 名男性和 38 名女性),对他们进行了全面评估,包括心脏自主神经功能评估、身体成分评估和生化分析。根据尤因的自律神经功能障碍标准,参与者被分为CAD阳性和CAD阴性。进行了单变量逻辑回归分析,以确定预测 CAD 的潜在因素。通过调整临床相关的协变量,进一步构建多变量逻辑回归模型,以确定CAD的独立预测因素:多变量逻辑回归分析显示,静息心率(HRrest)(几率比,置信区间:0.85,0.78-0.93;P = 0.001)和体脂百分比(BF%)(几率比,置信区间:0.78,0.64-0.96;P = 0.018)是显著的独立预测因素。接收者操作特征曲线分析显示,HRrest 和 BF% 的最佳临界值分别为 > 74.1 bpm 和 > 33.6%。多线性分析表明,方差膨胀因子(VIF)低于 3.结论的警戒线:结论:HRrest 和 BF% 是肥胖相关性高血压诱发 CAD 的重要独立预测因子。治疗策略应针对HRrest
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来源期刊
CiteScore
5.70
自引率
3.30%
发文量
57
期刊介绍: High Blood Pressure & Cardiovascular Prevention promotes knowledge, update and discussion in the field of hypertension and cardiovascular disease prevention, by providing a regular programme of independent review articles covering key aspects of the management of hypertension and cardiovascular diseases. The journal includes:   Invited ''State of the Art'' reviews.  Expert commentaries on guidelines, major trials, technical advances.Presentation of new intervention trials design.''Pros and Cons'' or round tables on controversial issues.Statements on guidelines from hypertension and cardiovascular scientific societies.Socio-economic issues.Cost/benefit in prevention of cardiovascular diseases.Monitoring of healthcare systems.News and views from the Italian Society of Hypertension (including abstracts).All manuscripts are subject to peer review by international experts. Letters to the editor are welcomed and will be considered for publication.
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