Effect of overweight and obesity on cardiac structure and function in elderly patients with hypertension

Abstract:

Objective：To investigate the effect of overweight and obesity on cardiac structure and function in elderly patients with hypertension. Methods：A total of 1183 patients ≥65 years of age with primary hypertension who were admitted to the First Affiliated Hospital of Chongqing Medical University from April 2014 to April 2018 were enrolled. The clinical data of patients including sex，age，body weight，systolic pressure，and diastolic pressure were collected. The echocardiographic parameters such as left atrial diame－ter（LAD），interventricular septal thickness（IVST），left ventricular posterior wall thickness（LVPWT），and left ventricular end-dias－tolic diameter（LVDd） were recorded，and left ventricular mass（LVM） and left ventricular mass index（LVMI） were calculated. Ac－cording to body mass index（BMI），61 patients were assigned to low-weight group（BMI<18.5 kg/m2），375 to normal-weight group （18.5 kg/m2≤BMI<23 kg/m2），530 to overweight group（23 kg/m2≤BMI<27.5 kg/m2），and 217 to obesity group（BMI≥27.5 kg/m2）. The clinical data and echocardiographic parameters were compared between the four groups，the correlation of BMI with the above indicators was analyzed，and an ordered multivariate regression analysis was conducted on BMI and correlated indicators. Results：Univariate correlation analysis showed that BMI was positively correlated with sex，body weight，smoking rate，alcohol consumption rate，history of hypertension，systolic pressure，constituent ratio of type 2 diabetes mellitus，fasting blood glucose，glycosylated hemoglobin，constituent ratios of fatty liver and gout，cardiac function，aortic dimension，IVST，LVPWT，LVDd，left ventricular end-systolic diameter（LVDs），LAD，LVW，LVMI，and consti－tution ratio of patients with mitral ratio of peak early to late di－astolic filling velocity（E/A）<1（P<0.05），but negatively corre－lated with age，high-density lipoprotein cholesterol，left ventricular fraction shortening（LVFS），and left ventricular ejection fraction（LVEF）（P<0.05）. The ordered multivariate regression analysis of sex，body weight，systolic pressure，history of hypertension，IVST，LVPWT，LVDd，LVDs，and other indicators showed that BMI was independently correlated with IVST，LVPWT，LVDd，LVM，and LV－MI（P<0.05）. Conclusion：In elderly patients with hypertension，overweight and obesity may lead to thicken the IVST and the LVPWT，enlargement of LVDd，and increases in LVM and LVMI. However，overweight and obesity are not independently correlated with cardiac systolic and diastolic function.