We aimed to characterize the combined effect of obesity and prehypertension on the left ventricular diastolic function and exercise capacity.
Design and method:
From health check-up data, we extracted those without known cardiovascular disease or hypertension (n = 736). The subjects were classified as 4 groups according to their body mass index (BMI) and systolic blood pressure (BP) level: non-obese individuals with an optimal BP (n = 279), non-obese individuals with prehypertension (n = 224), obese individuals with an optimal BP (n = 80), and obese individuals with prehypertension (n = 153). We defined obesity as a BMI equal to or greater than 25 kg/m2 and prehypertension as a systolic BP of 120–139 and/or diastolic BP of 80–89 mmHg. Diastolic dysfunction was defined as an E/e’ equal to or greater than 10 and exercise intolerance as a percent-predicted peak VO2 of < 80%.
Across the BP/BMI strata, a gradual increase in the E/e’ ratio was demonstrated even after an adjustment for the age and sex. A gradual decrease in the percent-predicted peak VO2 was observed. Obese individuals with prehypertension had the highest risk for diastolic dysfunction (OR 5.69, 95% CI 3.17–10.22), followed by obese individuals with an optimal BP (OR 3.26, 95% CI 1.61–6.59) and non-obese individuals with prehypertension (OR 3.26, 95% CI 1.61–6.59) compared with the reference group (non-obese group with optimal BP) after an adjustment for the age and sex. A similar risk gradient was also observed with regards to the exercise intolerance (corresponding HRs [95% CIs] were 3.58 [2.34–5.47], 3.30 [1.96–5.55], and 1.36 [0.91–2.04], respectively).
Both obesity and prehypertension adversely affected the diastolic function and exercise capacity, suggesting possible targets for primary prevention of heart failure.