An increased visceral-subcutaneous adipose tissue ratio is associated with difficult-to-treat hypertension in men

J Hypertens. 2010 Jun;28(6):1340-6. doi: 10.1097/HJH.0b013e328338158b.

Abstract

Background: Excess visceral adipose tissue (VAT) is considered to be a component in metabolic syndrome, an accumulation of cardiovascular risk factors that includes increased blood pressure; however, there are no previous data showing an association between increases in the VAT-subcutaneous adipose tissue (SAT) ratio and difficult-to-treat hypertension.

Methods: In 572 patients who had cardiovascular risk factors and who were under stable antihypertensive treatment, we evaluated whether the VAT-SAT ratio, as assessed by abdominal computed tomography, predicted difficult-to-treat hypertension, which we defined as an elevation of clinic blood pressure (i.e., clinic blood pressure >or=140/90 mmHg) during treatment with at least three antihypertensive drugs.

Results: In men, an elevated VAT-SAT ratio [odds ratio (OR) 1.44 per 1 SD (0.52), 95% confidence interval (CI) 1.08-1.92] and alcohol drinking habit (OR 2.16, 95% CI 1.07-4.36) were significant predictors of difficult-to-treat hypertension, independently of the presence of metabolic syndrome or the insulin level. However, when we included diuretic use in the diagnosis of difficult-to-treat hypertension (i.e., resistant hypertension), the significance of the VAT-SAT ratio disappeared (P = 0.06), and a decreased estimated glomerular filtration rate (OR 0.74 per 10 ml/min per 1.73 m, 95% CI 0.58-0.94) and alcohol drinking habit (OR 4.31, 95% CI 1.74-10.68) were the significant predictors. In contrast, in women, the VAT-SAT ratio did not predict difficult-to-treat hypertension (P = 0.18).

Conclusion: An increased VAT-SAT ratio was associated with difficult-to-treat hypertension in men, but not with resistant hypertension, suggesting that diuretic use may partly affect the relationship between the VAT-SAT ratio and difficult-to-treat hypertension.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Fat*
  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Risk Factors
  • Subcutaneous Fat*
  • Tomography, X-Ray Computed

Substances

  • Antihypertensive Agents