Ambulatory Blood Pressure Characteristics are Modulated by Age and Body Weight in Hypertensives: A Cohort Study of 35,367 Patients.

Abstract

Ambulatory blood pressure monitoring (ABPM) is increasingly recommended in clinical practice, but few large-scale studies were conducted on the characteristics of ABPM in obese hypertensive patients. The purpose of the present study was to assess the roles of age and body weight in modulating blood pressure (BP). In this cohort, 35,367 hypertensive patients were recruited and the International Obesity Task Force criteria were used to classify weight groups. Hypertension was defined according to the guidelines. According to ABPM records, 70.5% of participants had 24-h hypertension and 26.1% had dipper rhythm. Of these, 2.6% were underweight, 51.0% were normal, 38.2% were overweight, and 8.2% were in the obese category. In overweight and obese participants, 48%, and 45.1% of patients were non-dippers. Obese patients had higher 24h BP, especially morning BP surge. The prevalence of reverse-dipper rhythm hypertension and morning hypertension increased with age and obesity degree. A positive correlation between BP and variability was observed. Obese hypertensives had elevated 24h, diurnal and nocturnal heart rates. In hypertensives, ABPM characteristics were significantly modulated by body weight in the present cohort, implying that body weight control may constitute an approach for normalizing the ABPM pattern.