The Association Between Neck Circumference and Cardiac Electrical Remodeling in Chinese Hypertension Patients With Obesity: A Cross-Sectional Study.

Background: Hypertension and obesity promote cardiac electrical remodeling. Neck circumference (NC) was correlated with cardiometabolic diseases. This study investigated the association between NC and cardiac electrical remodeling among Chinese hypertensive adults with obesity.

Methods: 1,123 hospitalized hypertension patients were finally included after excluding patients with secondary hypertension, atrial fibrillation, severe hepatic or renal disorders, and cancers. They were classified into four groups according to obesity status and the median NC values. Atrial electrical remodeling was defined by P-wave dispersion (Pwd) and the maximum P-wave duration (Pmax). Increased transmural dispersion of ventricular repolarization (TDR) was defined by Tpeak-to-Tend interval (Tpe) and Tpe/QT. The correlations between NC and cardiac electrical remodeling were evaluated using restricted cubic spline (RCS), logistic regression, and receiver operating characteristic curve (ROC). Stratified analysis was applied to evaluate differences in different subgroups.

Results: Total participants included 479 (42.7%) obesity patients, of which the median NC was 41 cm. RCS showed the risk of atrial electrical remodeling increased exponentially when NC exceeded 37.73 cm. In hypertension patients with obesity, NC was independently associated with atrial electrical remodeling after adjusting for confounding factors. Stratified analysis showed a strong correlation between NC and atrial electrical remodeling in males and snoring patients. ROC suggested that NC can identify atrial electrical remodeling. Regarding the ventricular electrical remodeling, NC was only correlated with TDR, but not associated with traditional ventricular remodeling parameters.

Conclusions: Large NC is an independent risk factor for atrial electrical remodeling in Chinese hypertension patients with obesity, especially for males and snoring patients.