Abstract
The incidence of obesity has increased enormously in the past several decades, and has been described as a modern epidemic. Obesity is a major factor contributing to hypertension. To the best of our knowledge, no study of ambulatory blood pressure monitoring (ABPM) comparing men with women in relation to body mass indexes (BMI) has been performed. From December 2002 to May 2006, we performed 24-h ABPM in 5950 subjects (3102 men and 2848 women), with a wide range of BMI (range 15.9–53.2 kg/m2). We defined obese subjects as those with BMI⩾30.0 kg/m2, overweight subjects as those with BMI>25.0 and <30.0 kg/m2, and normal subjects as those with BMI⩽25.0 kg/m2. Data on 989 subjects (501 men and 488 women) aged from ⩾18 to ⩽69 years without antihypertensive treatment, atrial fibrillation or diabetes were included for analysis. We consistently found that obese men had the expected increased heart rate compared to normal and overweight men, whereas women (normal, overweight and obese) had similar HRs. In addition, normal and obese women had similar diastolic blood pressures (BP), as opposed to obese men, who had raised diastolic BP. These results may indicate that different pathogenetic mechanisms may be involved in the relationship between obesity and hypertension in men and women.
Similar content being viewed by others
References
York DA, Rössner S, Caterson I, Chen CM, James WP, Kumanyika S et al. Prevention Conference VII: obesity, a worldwide epidemic related to heart disease and stroke: group I: worldwide demographics of obesity. Circulation 2004; 110: e463–e470.
Wyatt HR . The prevalence of obesity. Prim Care 2003; 30: 267–279.
Keinan-Boker L, Noyman N, Chinich A, Green MS, Nitzan-Kaluski D . Overweight and obesity prevalence in Israel: finding of the first national health and nutrition survey (MABAT). Isr Med Assoc J 2005; 7: 219–223.
Bramlage P, Pittrow D, Wittchen HU, Kirch W, Boehler S, Lehnert H et al. Hypertension in overweight and obese primary care patients is highly prevalent and poorly controlled. Am J Hypertens 2004; 17: 904–910.
Garrison RJ, Kannel WB, Stokes 3rd J, Castelli WP . Incidence and precursors of hypertension in young adults: the Framingham Offspring Study. Prev Med 1987; 16: 235–251.
Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM . Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2003; 42: 878–884.
Kotsis V, Stabouli S, Pitiriga V, Toumanidis S, Papamichael C, Zakopoulos N . Ambulatory blood pressure monitoring and target organ damage: effects of age and sex. Blood Press Monit 2006; 11: 9–15.
Reckelhoff JF . Gender differences in the regulation of blood pressure. Hypertension 2001; 37: 1199–1208.
Perloff D, Socolow M, Cowan R . The prognostic value of ambulatory blood pressures. JAMA 1983; 249: 2792–2798.
Khattar RS, Swales JD, Banfield A, Dore C, Senior R, Lahiri A . Prediction of coronary and cerebrovascular morbidity and mortality by direct continuous ambulatory blood pressure monitoring in essential hypertension. Circulation 1999; 100: 1071–1076.
Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens 2002; 20: 2183–2189.
O'Brien E, Waeber B, Parati G, Staessen J, Myers MG . Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ 2001; 322: 531–536.
Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension 2005; 45: 142–161.
Eison H, Phillips RA, Ardeljan M, Krakoff LR . Differences in ambulatory blood pressure between men and women with mild hypertension. J Hum Hypertens 1990; 4: 400–404.
O'Sullivan C, Duggan J, Atkins N, O'Brien E . Twenty-four-hour ambulatory blood pressure in community-dwelling elderly men and women, aged 60 – 102 years. J Hypertens 2003; 21: 1641–1647.
Kotsis V, Stabouli S, Bouldin M, Low A, Toumanidis S, Zakopoulos N . Impact of obesity on 24-hour ambulatory blood pressure and hypertension. Hypertension 2005; 45: 602–607.
Jones PP, Snitker S, Skinner JS, Ravussin E . Gender differences in muscle sympathetic nerve activity: effect of body fat distribution. Am J Physiol 1996; 270 (2 Part 1): E363–E366.
Narkiewicz K, Somers VK . Interactive effect of heart rate and muscle sympathetic nerve activity on blood pressure. Circulation 1999; 100: 2514–2518.
Esler M, Rumantir M, Kaye D, Lambert G . The sympathetic neurobiology of essential hypertension: disparate influences of obesity, stress, and noradrenaline transporter dysfunction? Am J Hypertens 2001; 14: 139s–146s.
Landsberg L . Diet, obesity and hypertension: a hypothesis involving insulin, the sympathetic nervous system, and adaptive thermogenesis. Q J Med 1986; 61 (236): 1081–1090.
Weyer C, Pratley RE, Snitker S, Spraul M, Ravussin E, Tataranni PA . Ethnic differences in insulinemia and sympathetic tone as links between obesity and blood pressure. Hypertension 2000; 36: 531–537.
Grassi G, Seravalle G, Dell'Oro R, Turri C, Bolla GB, Mancia G . Adrenergic and reflex abnormalities in obesity-related hypertension. Hypertension 2000; 36: 538–542.
Wofford MR, Anderson Jr DC, Brown CA, Jones DW, Miller ME, Hall JE . Antihypertensive effect of alpha- and beta-adrenergic blockade in obese and lean hypertensive subjects. Am J Hypertens 2001; 14: 694–698.
Sica DA . What are the influences of salt, potassium, the sympathetic nervous system, and the renin-angiotensin system on the circadian variation in blood pressure? Blood Press Monit 1999; 4 (Suppl 2): S9–S16.
Sherwood A, Steffen PR, Blumenthal JA, Kuhn C, Hinderliter AL . Nighttime blood pressure dipping: the role of the sympathetic nervous system. Am J Hypertens 2002; 15: 111–118.
Hall JE, Hildebrandt DA, Kuo J . Obesity hypertension: role of leptin and sympathetic nervous system. Am J Hypertens 2001; 14: 103S–115S.
Correia ML, Haynes WG . Leptin, obesity and cardiovascular disease. Curr Opin Nephrol Hypertens 2004; 13: 215–223.
Fruhbeck G . Pivotal role of nitric oxide in the control of blood pressure after leptin administration. Diabetes 1999; 48: 903–908.
Rumantir MS, Vaz M, Jennings GL, Collier G, Kaye DM, Seals DR et al. Neural mechanisms in human obesity-related hypertension. J Hypertens 1999; 17: 1125–1133.
Rosenbaum M, Leibel RL . Clinical review 107: role of gonadal steroids in the sexual dimorphisms in body composition and circulating concentrations of leptin. J Clin Endocrinol Metab 1999; 84: 1784–1789.
Orshal JM, Khalil RA . Gender, sex hormones, and vascular tone. Am J Physiol Regul Integr Comp Physiol 2004; 286: R233–R249.
James GD, Sealey JE, Miller F, Alderman M, Madhavan S, Laragh JH . Renin relationship to sex, race and age in a normotensive population. J Hypertens 1986; 4: S387–S389.
Dalton M, Cameron AJ, Zimmet PZ, Shaw JE, Jolley D, Dunstan DW et al. Waist circumference, waist-hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults. J Intern Med 2003; 254: 555–563.
Acknowledgements
We thank Professor Yossi Hillel, The Robert H Smith Institute of Plant Science and Genetics, The Hebrew University of Jerusalem for help in statistical analysis of data; and Tamy Aflalo, Natalie Berkovitch and Olga Kolomier, technicians of ‘Meuhedet’ Sick Fund for help in data collection.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kagan, A., Faibel, H., Ben-Arie, G. et al. Gender differences in ambulatory blood pressure monitoring profile in obese, overweight and normal subjects. J Hum Hypertens 21, 128–134 (2007). https://doi.org/10.1038/sj.jhh.1002118
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jhh.1002118
- Springer Nature Limited
Keywords
This article is cited by
-
Spatial analysis of gender variation in the prevalence of hypertension among the middle-aged and elderly population in Zhejiang Province, China
BMC Public Health (2016)
-
Blood Pressure Dipping: Ethnicity, Sleep Quality, and Sympathetic Nervous System Activity
American Journal of Hypertension (2011)
-
Ambulatory blood pressure monitoring in childhood and adult obesity
Current Hypertension Reports (2009)