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Clinical Studies and Practice

Is obesity predictive of cardiovascular dysfunction independent of cardiovascular risk factors?

International Journal of Obesity volume 39, pages 244–253 (2015)Cite this article

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Abstract

Introduction:

Obesity is thought to exert detrimental effects on the cardiovascular (CV) system. However, this relationship is impacted by the co-occurrence of CV risk factors, type 2 diabetes (T2DM) and overt disease. We examined the relationships between obesity, assessed by body mass index (BMI) and waist circumference (WC), and CV function in 102 subjects without overt CV disease. We hypothesized that obesity would be independently predictive of CV remodeling and functional differences, especially at peak exercise.

Methods:

Brachial (bSBP) and central (cSBP) systolic pressure, carotid-to-femoral pulse wave velocity (PWVcf) augmentation index (AGI; by SphygmoCor), and carotid remodeling (B-mode ultrasound) were examined at rest. Further, peak exercise cardiac imaging (Doppler ultrasound) was performed to measure the coupling between the heart and arterial system.

Results:

In backward elimination regression models, accounting for CV risk factors, neither BMI nor WC were predictors of carotid thickness or PWVcf; rather age, triglycerides and hypertension were the main determinants. However, BMI and WC predicted carotid cross-sectional area and lumen diameter. When examining the relationship between body size and SBP, BMI (β=0.32) and WC (β=0.25) were predictors of bSBP (P<0.05), whereas, BMI was the only predictor of cSBP (β=0.22, P<0.05) indicating a differential relationship between cSBP, bSBP and body size. Further, BMI (β=−0.26) and WC (β=−0.27) were independent predictors of AGI (P<0.05). As for resting cardiac diastolic function, WC seemed to be a better predictor than BMI. However, both BMI and WC were inversely and independently related to arterial-elastance (net arterial load) and end-systolic elastance (cardiac contractility) at rest and peak exercise.

Conclusion:

These findings illustrate that obesity, without T2DM and overt CV disease, and after accounting for CV risk factors, is susceptible to pathophysiological adaptations that may predispose individuals to an increased risk of CV events.

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Acknowledgements

We thank Charles Murray and Diana Stofcheck for their help with the echocardiography. This study was supported in part by the American Heart Association 11CRP7370056 (PDC), National Heart, Lung, Blood Institute T32- HL090610 (SBF) and the National Institute of General Medical Sciences of the National Institutes of Health under Award Number U54GM104942. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author Contributions

EDV, SBF and PDC contributed in the conception, design, data analysis, drafting and revising of the manuscript. DAD, DEB, KL and JCF contributed in data collection, interpretation of results, writing and reviewing of the manuscript.

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Authors and Affiliations

  1. Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV, USA

    E DeVallance, S B Fournier, D A Donley, D E Bonner, K Lee & P D Chantler

  2. Center for Cardiovascular and Respiratory Sciences, School of Medicine, West Virginia University, Morgantown, WV, USA

    E DeVallance, S B Fournier, J C Frisbee & P D Chantler

  3. Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, WV, USA

    J C Frisbee

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  1. E DeVallance
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Correspondence to P D Chantler.

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DeVallance, E., Fournier, S., Donley, D. et al. Is obesity predictive of cardiovascular dysfunction independent of cardiovascular risk factors?. Int J Obes 39, 244–253 (2015). https://doi.org/10.1038/ijo.2014.111

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