Abstract 10782: Differential Effects of Body Mass Index and Blood Pressure from Childhood to Adulthood on Left Ventricular Remodeling Patterns in Adults: The Bogalusa Heart Study
Introduction: Obesity and hypertension are major risk factors for left ventricular (LV) hypertrophy, an important predictor of cardiovascular morbidity and mortality. This study tested the hypothesis that childhood, adulthood and long-term measures of body mass index (BMI) and blood pressure (BP) have a different impact on development of LV remodeling patterns in adulthood.
Methods: The longitudinal study cohort consisted of 721 asymptomatic adults (512 whites and 209 blacks; 39.9% males; age=28.8-50.1 years; average=41.8 years) enrolled in the Bogalusa Heart Study. Subjects were examined for cardiovascular risk factor variables 6 times from childhood to adulthood since 1973 and LV dimensions as adults in 2008-2010. Four LV geometry types were identified as normal, concentric remodeling, eccentric and concentric hypertrophy. The long-term burden of BMI and systolic BP was measured as the area under the curve (AUC).
Results: Compared with whites, blacks had higher prevalence of concentric hypertrophy (24.4% vs 15.2%, p=0.004). In multivariable Logistic regression analyses using normal geometry as a control shown in the table, BMI had stronger associations with LV hypertrophy than systolic BP in terms of childhood (the first measurement), adulthood (the last measurement) and AUC values. Furthermore, BMI was predictive of both concentric and eccentric hypertrophy; whereas systolic BP was not associated with eccentric hypertrophy when BMI was included in the model. The standardized regression coefficients of systolic BP AUC on LV relative wall thickness were greater than those of BMI AUC (0.15 vs 0.08). All the above associations did not differ significantly between black and white individuals.
Conclusions: These findings suggest that the childhood and life course burden of obesity and elevated BP play different roles in the pathogenesis of LV hypertrophy patterns in adulthood.
- © 2011 by American Heart Association, Inc.