Central aortic pulsatile hemodynamics in obese premenopausal women

Ounis–Skali, Nadia; Bentley–Lewis, Rhonda; Mitchell, Gary F.; Solomon, Scott; Seely, Ellen W.

doi:10.1016/j.jash.2007.06.004

« Previous Next »Journal of the American Society of Hypertension
Volume 1, Issue 5 , Pages 341-346, September 2007

Central aortic pulsatile hemodynamics in obese premenopausal women

Nadia Ounis–Skali, MD
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
Rhonda Bentley–Lewis, MD
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
Gary F. Mitchell, MD
- Cardiovascular Engineering, Waltham, Massachusetts, USA
- Dr. Gary F. Mitchell is the owner of Cardiovascular Engineering, Inc. This company designs and manufactures devices that measure vascular stiffness and these devices are used in clinical trials that evaluate the effects of diseases and interventions on vascular stiffness. He receives a salary as a result of this relationship.
Scott Solomon, MD
- Division of Cardiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
Ellen W. Seely, MD
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Corresponding author: Ellen W. Seely, MD, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts 02115. Tel: 617-732-5661; fax: 617-732-5764.

Received 13 March 2007; accepted 7 June 2007.

Abstract

Obesity is a known risk factor for cardiovascular disease (CVD) but the mechanism by which obesity contributes to cardiovascular risk is not well understood. Arterial stiffness is a CVD risk factor associated with obesity. We studied 16 obese body mass index (BMI > 30) and 10 lean (BMI < 25) healthy premenopausal women. We measured fasting glucose, insulin, and lipids, blood pressure, and arterial tonometry to assess arterial stiffness. Obese women had higher glucose, insulin, total cholesterol and triglyceride levels, blood pressures, cardiac output, and peak flow. Characteristic impedance was lower (146 ± 31 [(dyne · s) · cm⁻⁵] vs. 187 ± 48 [(dyne · s) · cm⁻⁵]; P = .01), aortic diameter was greater (2.54 ± 0.20 cm vs. 2.29 ± 0.21 cm; P < .01), and peripheral pulse pressure was similar in obese compared with lean women. Obesity in premenopausal women is associated with increased cardiac output and peak aortic flow. Increased aortic diameter in obese women was associated with reduced characteristic impedance, potentially preventing an increase in peripheral pulse pressure despite elevated flow, which suggests proximal aortic remodeling. When aortic remodeling and compensation for increased hemodynamic demands are limited by environmental or genetic interference, hypertension or CVD may result.

Keywords: Arterial stiffness, aortic compliance, tonometry, body mass index