Association between non-alcoholic hepatic steatosis and hyper reactive blood pressure response on the exercise treadmill test

A. G. Laurinavicius, M. S. Bittencourt, Michael Blaha, F. C. Nary, N. M. Kashiwagi, R. D. Conceiçao, R. S. Meneghelo, R. R. Prado, J. A M Carvalho, K. Nasir, Roger S Blumenthal, R. D. Santos

Research output: Contribution to journalArticle

Abstract

Aims: Non-alcoholic hepatic steatosis (HS) is associated with hypertension and increased cardiovascular risk. While Blood pressure hyper-reactive response (HRR) during peak exercise indicates an increased risk of incident hypertension and increased cardiovascular risk, no data on the association of non-alcoholic HS and HRR exists. In this study, we have evaluated the association of HS with HRR. Methods: We included 13 410 consecutive individuals with a mean age: 42.4 6 8.9 years, 3561 (26.6%) female with normal resting blood pressure and without a previous diagnosis of hypertension, who underwent symptom limited exercise treadmill test, abdominal ultrasonography and clinical and laboratory evaluation. HS was detected by abdominal ultrasonography. HRR was defined by a peak exercise systolic blood pressure > 220mmHg and/or elevation of 15mmHg or more in diastolic blood pressure from rest to peak exercise. Results: The prevalence of HS was 29.5% (n = 3956). Overall, 4.6% (n = 619) of the study population presented a HRR. Subjects with HS had a higher prevalence of HRR (8.1 vs. 3.1%, odds ratio 2.8, 95% CI 2.4-3.3, P < 0.001). After adjustment for body mass index, waist circumference, fasting plasma glucose and low density lipoprotein cholesterol, HS (odds ratio 1.4, 95% CI 1.1-1.6, P = 0.002) remained independently associated with HRR. HS was additive to obesity markers in predicting exercise HRR. Conclusions: Non-alcoholic HS is independently associated with hyper-reactive exercise blood pressure response.

Original languageEnglish (US)
Article numberhcw003
Pages (from-to)531-537
Number of pages7
JournalQJM
Volume109
Issue number8
DOIs
StatePublished - Aug 1 2016

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Exercise Test
Blood Pressure
Liver
Hypertension
Ultrasonography
Odds Ratio
Waist Circumference
LDL Cholesterol
Fasting
Body Mass Index
Obesity
Glucose
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Laurinavicius, A. G., Bittencourt, M. S., Blaha, M., Nary, F. C., Kashiwagi, N. M., Conceiçao, R. D., ... Santos, R. D. (2016). Association between non-alcoholic hepatic steatosis and hyper reactive blood pressure response on the exercise treadmill test. QJM, 109(8), 531-537. [hcw003]. https://doi.org/10.1093/qjmed/hcw003

Association between non-alcoholic hepatic steatosis and hyper reactive blood pressure response on the exercise treadmill test. / Laurinavicius, A. G.; Bittencourt, M. S.; Blaha, Michael; Nary, F. C.; Kashiwagi, N. M.; Conceiçao, R. D.; Meneghelo, R. S.; Prado, R. R.; Carvalho, J. A M; Nasir, K.; Blumenthal, Roger S; Santos, R. D.

In: QJM, Vol. 109, No. 8, hcw003, 01.08.2016, p. 531-537.

Research output: Contribution to journalArticle

Laurinavicius, AG, Bittencourt, MS, Blaha, M, Nary, FC, Kashiwagi, NM, Conceiçao, RD, Meneghelo, RS, Prado, RR, Carvalho, JAM, Nasir, K, Blumenthal, RS & Santos, RD 2016, 'Association between non-alcoholic hepatic steatosis and hyper reactive blood pressure response on the exercise treadmill test', QJM, vol. 109, no. 8, hcw003, pp. 531-537. https://doi.org/10.1093/qjmed/hcw003
Laurinavicius AG, Bittencourt MS, Blaha M, Nary FC, Kashiwagi NM, Conceiçao RD et al. Association between non-alcoholic hepatic steatosis and hyper reactive blood pressure response on the exercise treadmill test. QJM. 2016 Aug 1;109(8):531-537. hcw003. https://doi.org/10.1093/qjmed/hcw003
Laurinavicius, A. G. ; Bittencourt, M. S. ; Blaha, Michael ; Nary, F. C. ; Kashiwagi, N. M. ; Conceiçao, R. D. ; Meneghelo, R. S. ; Prado, R. R. ; Carvalho, J. A M ; Nasir, K. ; Blumenthal, Roger S ; Santos, R. D. / Association between non-alcoholic hepatic steatosis and hyper reactive blood pressure response on the exercise treadmill test. In: QJM. 2016 ; Vol. 109, No. 8. pp. 531-537.
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abstract = "Aims: Non-alcoholic hepatic steatosis (HS) is associated with hypertension and increased cardiovascular risk. While Blood pressure hyper-reactive response (HRR) during peak exercise indicates an increased risk of incident hypertension and increased cardiovascular risk, no data on the association of non-alcoholic HS and HRR exists. In this study, we have evaluated the association of HS with HRR. Methods: We included 13 410 consecutive individuals with a mean age: 42.4 6 8.9 years, 3561 (26.6{\%}) female with normal resting blood pressure and without a previous diagnosis of hypertension, who underwent symptom limited exercise treadmill test, abdominal ultrasonography and clinical and laboratory evaluation. HS was detected by abdominal ultrasonography. HRR was defined by a peak exercise systolic blood pressure > 220mmHg and/or elevation of 15mmHg or more in diastolic blood pressure from rest to peak exercise. Results: The prevalence of HS was 29.5{\%} (n = 3956). Overall, 4.6{\%} (n = 619) of the study population presented a HRR. Subjects with HS had a higher prevalence of HRR (8.1 vs. 3.1{\%}, odds ratio 2.8, 95{\%} CI 2.4-3.3, P < 0.001). After adjustment for body mass index, waist circumference, fasting plasma glucose and low density lipoprotein cholesterol, HS (odds ratio 1.4, 95{\%} CI 1.1-1.6, P = 0.002) remained independently associated with HRR. HS was additive to obesity markers in predicting exercise HRR. Conclusions: Non-alcoholic HS is independently associated with hyper-reactive exercise blood pressure response.",
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AU - Laurinavicius, A. G.

AU - Bittencourt, M. S.

AU - Blaha, Michael

AU - Nary, F. C.

AU - Kashiwagi, N. M.

AU - Conceiçao, R. D.

AU - Meneghelo, R. S.

AU - Prado, R. R.

AU - Carvalho, J. A M

AU - Nasir, K.

AU - Blumenthal, Roger S

AU - Santos, R. D.

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N2 - Aims: Non-alcoholic hepatic steatosis (HS) is associated with hypertension and increased cardiovascular risk. While Blood pressure hyper-reactive response (HRR) during peak exercise indicates an increased risk of incident hypertension and increased cardiovascular risk, no data on the association of non-alcoholic HS and HRR exists. In this study, we have evaluated the association of HS with HRR. Methods: We included 13 410 consecutive individuals with a mean age: 42.4 6 8.9 years, 3561 (26.6%) female with normal resting blood pressure and without a previous diagnosis of hypertension, who underwent symptom limited exercise treadmill test, abdominal ultrasonography and clinical and laboratory evaluation. HS was detected by abdominal ultrasonography. HRR was defined by a peak exercise systolic blood pressure > 220mmHg and/or elevation of 15mmHg or more in diastolic blood pressure from rest to peak exercise. Results: The prevalence of HS was 29.5% (n = 3956). Overall, 4.6% (n = 619) of the study population presented a HRR. Subjects with HS had a higher prevalence of HRR (8.1 vs. 3.1%, odds ratio 2.8, 95% CI 2.4-3.3, P < 0.001). After adjustment for body mass index, waist circumference, fasting plasma glucose and low density lipoprotein cholesterol, HS (odds ratio 1.4, 95% CI 1.1-1.6, P = 0.002) remained independently associated with HRR. HS was additive to obesity markers in predicting exercise HRR. Conclusions: Non-alcoholic HS is independently associated with hyper-reactive exercise blood pressure response.

AB - Aims: Non-alcoholic hepatic steatosis (HS) is associated with hypertension and increased cardiovascular risk. While Blood pressure hyper-reactive response (HRR) during peak exercise indicates an increased risk of incident hypertension and increased cardiovascular risk, no data on the association of non-alcoholic HS and HRR exists. In this study, we have evaluated the association of HS with HRR. Methods: We included 13 410 consecutive individuals with a mean age: 42.4 6 8.9 years, 3561 (26.6%) female with normal resting blood pressure and without a previous diagnosis of hypertension, who underwent symptom limited exercise treadmill test, abdominal ultrasonography and clinical and laboratory evaluation. HS was detected by abdominal ultrasonography. HRR was defined by a peak exercise systolic blood pressure > 220mmHg and/or elevation of 15mmHg or more in diastolic blood pressure from rest to peak exercise. Results: The prevalence of HS was 29.5% (n = 3956). Overall, 4.6% (n = 619) of the study population presented a HRR. Subjects with HS had a higher prevalence of HRR (8.1 vs. 3.1%, odds ratio 2.8, 95% CI 2.4-3.3, P < 0.001). After adjustment for body mass index, waist circumference, fasting plasma glucose and low density lipoprotein cholesterol, HS (odds ratio 1.4, 95% CI 1.1-1.6, P = 0.002) remained independently associated with HRR. HS was additive to obesity markers in predicting exercise HRR. Conclusions: Non-alcoholic HS is independently associated with hyper-reactive exercise blood pressure response.

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