scholarly journals Impact of the Duration and Degree of Hypertension and Body Weight on New-Onset Atrial Fibrillation

Hypertension ◽  
2019 ◽  
Vol 74 (5) ◽  
Author(s):  
Yun Gi Kim ◽  
Kyung-Do Han ◽  
Jong-Il Choi ◽  
Ki Yung Boo ◽  
Do Young Kim ◽  
...  

Hypertension and obesity are known risk factors for atrial fibrillation (AF). However, it is unclear whether uncontrolled, long-standing hypertension has a particularly profound effect on AF. Because they have a similar underlying pathophysiology, hypertension and obesity could act synergistically in the context of AF. We evaluated how various stages of hypertension and body weight status affect new-onset AF. We analyzed a total of 9 797 418 participants who underwent a national health checkup. Hypertension was classified into 5 stages: nonhypertension, prehypertension, hypertension without medication, hypertension with medication <5 years, and hypertension with medication ≥5 years. The participants were also stratified based on body mass index and waist circumference. During the 80 130 161 person×years follow-up, a total of 196 136 new-onset AF cases occurred. The incidence of new-onset AF gradually increased among the 5 stages of hypertension: the adjusted hazard ratio for each group was 1 (reference), 1.145, 1.390, 1.853, and 2.344 for each stage of hypertension. A graded escalation in the risk of new-onset AF was also observed in response to increased systolic and diastolic blood pressure. The incidence of new-onset AF correlated with body mass index and waist circumference, with obese people having a higher risk than others. Hypertension and obesity acted synergistically: obese people with hypertension on medication ≥5 years had the highest risk of AF. In conclusion, the degree and duration of hypertension, as well as the presence of hypertension, were important factors for new-onset AF. Body weight status was significantly associated with new-onset AF and acted synergistically with hypertension.

2020 ◽  
Vol 105 (3) ◽  
pp. e511-e519
Author(s):  
Mengyi Liu ◽  
Zhuxian Zhang ◽  
Chun Zhou ◽  
Panpan He ◽  
Jing Nie ◽  
...  

Abstract Context The association of the combination of body mass index (BMI) and waist circumference (WC) with the risk of proteinuria has previously not been comprehensively investigated and results have been inconclusive. Objective To examine BMI and WC in relation to new-onset proteinuria in Chinese hypertensive patients. Design and Setting Post hoc analysis of the renal substudy of the China Stroke Primary Prevention Trial (CSPPT). Patients 10 805 hypertensive patients without proteinuria at baseline. Main Outcome Measure The primary outcome was new-onset proteinuria, defined as a urine dipstick protein reading ≥ 1 + at the exit visit, after a median follow-up duration of 4.4 years. Results When analyzed separately, increased BMI (≥ 28 kg/m2, quartile 4; odds ratio [OR], 1.36; 95% confidence interval [CI], 1.08–1.72), or increased WC (≥ 91cm for females, quartile 4; OR, 1.35; 95% CI, 1.01–1.80; and ≥ 79 cm for males, quartile 2–4; OR, 1.60; 95% CI, 1.03–2.50) were each significantly associated with higher risk of new-onset proteinuria. When analyzed jointly, participants without increased BMI and increased WC had the lowest risk, while those with both increased BMI and increased WC had the highest risk of proteinuria (OR, 1.61; 95% CI, 1.21–2.13). Notably, participants with only increased WC also had significantly increased risk of proteinuria (OR, 1.39; 95% CI, 1.04–1.85). Conclusion In Chinese hypertensive patients, increased BMI and increased WC were individually and jointly associated with a higher risk of new-onset proteinuria, underscoring the value of monitoring both BMI and WC in assessing proteinuria risk.


2013 ◽  
Vol 37 (3) ◽  
pp. 235-242 ◽  
Author(s):  
W Bhoomika ◽  
Ramakrishna Y ◽  
AK Munshi

Aim: This study was undertaken to evaluate the relationship between Severe Early Childhood Caries (S-ECC) and Body Mass Index (BMI) in the absence of any underlying medical condition for the school going (3 to 6 years old) children of Mathura city, India. Method: One hundred caries free children (50 boys and 50 girls) and one hundred children (50 boys and 50 girls) affected with S-ECC in the age range of 3-6 years without any contributing medical history were included in the study. Measurements of the weight (kg) and height (m) were done using a standard balanced beam scale and stadiometer. The BMI (kg/m2) was determined and the body weight status was evaluated using CDC based classification for each child. Independent t-test was used to evaluate whether the weight, height and BMI of S-ECC children is significantly different from caries free children. Result: Although the weight of the S-ECC children is more when compared to the normal children, the difference is not statistically significant. However, the mean BMI of S-ECC children is more when compared to the caries free children which was found to be statistically significant at p&lt;0.05. The body weight status of the Normal and S-ECC affected children based on the CDC classification revealed that 48% have been classified in underweight category and 43% in normal weight category and very few children are found to be at risk of overweight and overweight. Conclusions: A positive correlation between the BMI and S-ECC was observed in this study. 51% of caries free children and 45% of S-ECC children were classified in underweight category based on CDC classification.


2021 ◽  
Vol 26 ◽  
pp. 2515690X2110110
Author(s):  
Wiraphol Phimarn ◽  
Bunleu Sungthong ◽  
Hiroyuki Itabe

Aim. The efficacy of triphala on lipid profile, blood glucose and anthropometric parameters and its safety were assessed. Methods. Databases such as PubMed, ScienceDirect, Web of Science, and Thai Library Integrated System (ThaiLIS) were systematically searched to review current evidence of randomized controlled trials (RCT) on triphala. RCTs investigating the safety and efficacy of triphala on lipid profile, blood glucose and anthropometric parameters were included. Study selection, data extraction, and quality assessment were performed independently by 2 authors. Results. Twelve studies on a total of 749 patients were included. The triphala-treated groups showed significantly reduced low-density lipoprotein-cholesterol, total cholesterol and triglyceride in 6 studies. Five RCTs demonstrated triphala-treated groups led to statistically significant decrease in body weight, body mass index and waist circumference of obese patients. Moreover, triphala significantly decreased fasting blood glucose level in diabetic patients but not in people without diabetes. No serious adverse event associated with triphala was reported during treatment. Conclusions. This review summarized a current evidence to show triphala might improve the lipid profile, blood glucose, the body weight, body mass index and waist circumference under certain conditions. However, large well-designed RCTs are required to confirm this conclusion.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Joseph Decker ◽  
Wendy Wang ◽  
Faye L Norby ◽  
Romil Parikh ◽  
Jorge L Reyes ◽  
...  

Introduction: The proportions of obese and aging adults are rapidly growing. While obesity and advancing age are associated with atrial fibrillation (AF), data are limited on weight change in the elderly as a risk factor for premature atrial contractions (PACs)—which are known to precede AF—or AF. Hypothesis: Compared to a stable body mass index (BMI) over time, increasing BMI will be associated with a higher PAC frequency and AF in elderly participants in ARIC. Methods: We included N=2,070 ARIC participants [age mean ± SD 79 ± 4.5 years, 59% female] without known AF who attended visit 6 and wore an ambulatory ECG-monitoring device (Zio XT® Patch, iRhythm Technologies Inc.) for ≥48 hours. BMI change was defined as change between V5 (2011-13) and V6 (2016-17) and was categorized into 4 groups: >10% decrease, 2 to 10% decrease, -2 to 2% change (stable BMI) and > 2% increase. PAC frequency was defined as percent of beats that are PACs. Linear regression was used to evaluate the association between BMI change and % PAC. Incident AF was ascertained after V6 through 2018 from hospital discharge codes and death certificates. Logistic regression was used to evaluate the association between BMI change and incident AF. Results: Median PACs per hour were 8.84. Participants with >2% BMI increase had 0.35% (95% CI: 0.06%-0.64%) higher frequency of PACs compared to those with stable BMI after multivariable adjustment (Table). After a mean (SD) follow-up of 19 (7) months, there were 82 incident AF cases. Compared to stable BMI, both >2% BMI increase and 2 to 10% decrease were nonsignificantly associated with higher odds of AF compared with stable BMI after multivariable adjustment (Table). Conclusion: Increasing BMI in the elderly is associated with higher PAC frequency and is nonsignificantly associated with higher odds of AF compared to stable BMI. This finding suggests that weight management, which is currently emphasized in middle age, may also apply in late-life to prevent atrial arrhythmias.


Author(s):  
Futoon S. Alobiri ◽  
Roaa A. Alharbi ◽  
Mohammed R. Algethami ◽  
Raghdah H. Ateeq ◽  
Aseel M. Badurayq ◽  
...  

Aim: Identify the relation between poor esteem for body image and weight-related behaviors. The results will help increase awareness and improve students’ lifestyles to have a better body image and achieve ideal body weight. Methods: A cross-sectional study was conducted among King Abdulaziz University medical students (n= 460) between July to the end of August 2019. Data was collected using the International physical activity questionnaire (IPAQ), figure rating scale (FRS) and analyzed using SPSS software. Result: The results showed that the average Body Mass Index (BMI) was 24.80 ± 11.89. Participant sex was an important factor influencing the prevalence of obesity; male students were more obese than female students with a significant difference (p<0.001). The level of body satisfaction was also affected by gender. Students in preclinical years were more likely to gain weight more than clinical years students. Conclusion: The results show a significant relationship between body satisfaction and gender (P<0.0001) despite having diverse BMIs. Overweight and obese males and females' participants had the lowest body satisfaction. Females who were too thin and had low BMIs described themselves as normal, while males describe themselves as too thin. Conversely, females with high BMIs described themselves as too fat, while males described themselves as normal. This could be due to different factors. Also, underweight females and males have high body satisfaction, which can lead to dangerous behaviors to maintain low body weight which cause negative health consequences.


2018 ◽  
Vol 25 (15) ◽  
pp. 1646-1652 ◽  
Author(s):  
Lars E Garnvik ◽  
Vegard Malmo ◽  
Imre Janszky ◽  
Ulrik Wisløff ◽  
Jan P Loennechen ◽  
...  

Background Atrial fibrillation is the most common heart rhythm disorder, and high body mass index is a well-established risk factor for atrial fibrillation. The objective of this study was to examine the associations of physical activity and body mass index and risk of atrial fibrillation, and the modifying role of physical activity on the association between body mass index and atrial fibrillation. Design The design was a prospective cohort study. Methods This study followed 43,602 men and women from the HUNT3 study in 2006–2008 until first atrial fibrillation diagnosis or end of follow-up in 2015. Atrial fibrillation diagnoses were collected from hospital registers and validated by medical doctors. Cox proportional hazard regression analysis was performed to assess the association between physical activity, body mass index and atrial fibrillation. Results During a mean follow-up of 8.1 years (352,770 person-years), 1459 cases of atrial fibrillation were detected (4.1 events per 1000 person-years). Increasing levels of physical activity were associated with gradually lower risk of atrial fibrillation ( p trend 0.069). Overweight and obesity were associated with an 18% (hazard ratio 1.18, 95% confidence interval 1.03–1.35) and 59% (hazard ratio 1.59, 95% confidence interval 1.37–1.84) increased risk of atrial fibrillation, respectively. High levels of physical activity attenuated some of the higher atrial fibrillation risk in obese individuals (hazard ratio 1.53, 95% confidence interval 1.03–2.28 in active and 1.96, 95% confidence interval 1.44–2.67 in inactive) compared to normal weight active individuals. Conclusion Overweight and obesity were associated with increased risk of atrial fibrillation. Physical activity offsets some, but not all, atrial fibrillation risk associated with obesity.


2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Rachel M. Kaplan ◽  
Yoshihiro Tanaka ◽  
Rod S. Passman ◽  
Michelle Fine ◽  
Laura J. Rasmussen‐Torvik ◽  
...  

Background Direct‐acting oral anticoagulants are now the preferred method of anticoagulation in patients with atrial fibrillation. Limited data on efficacy and safety of these fixed‐dose regimens are available in severe obesity where drug pharmacokinetics and pharmacodynamics may be altered. The objectives of this study were to evaluate efficacy and safety in patients with atrial fibrillation taking direct‐acting oral anticoagulants across body mass index (BMI) categories in a contemporary, real‐world population. Methods and Results We performed a retrospective study of patients with atrial fibrillation at an integrated multisite healthcare system. Patients receiving a direct‐acting oral anticoagulant prescription and ≥12 months of follow‐up between 2010 and 2017 were included. The primary efficacy and safety outcomes were ischemic stroke or systemic embolism and intracranial hemorrhage. We performed Cox proportional hazards modeling to compute hazard ratios (HRs) adjusted for CHA 2 DS 2 ‐VASc score to examine differences by excess BMI categories relative to normal BMI. Of 7642 patients, mean±SD age was 69±12 years with a median (interquartile range) follow‐up of 3.8 (2.2–6.0) years. Approximately 22% had class 1 obesity and 19% had class 2 or 3 obesity. Stroke risks were similar in patients with and without obesity (HR, 1.2; 95% CI, 0.5–2.9; and HR, 0.68; 95% CI, 0.23–2.0 for class 1 and class 2 or 3 obesity compared with normal BMI, respectively). Risk of intracranial hemorrhage was also similar in class 1 and class 2 or 3 obesity compared with normal BMI (HR, 0.64; 95% CI, 0.35–1.2; and HR, 0.66; 95% CI, 0.35–1.2, respectively). Conclusions Direct‐acting oral anticoagulants demonstrated similar efficacy and safety across all BMI categories, even at high weight values.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Chang Seong Kim ◽  
Hong Sang Choi ◽  
Eun hui Bae ◽  
Seong Kwon Ma ◽  
Soo Wan Kim

Abstract Background and Aims Overweight or obese patients with autosomal dominant polycystic kidney disease (ADPKD) are associated with the decline of glomerular filtration rate. However, little is known about the annual rate of change in total kidney volume (TKV) in patients with ADPKD according to the body mass index (BMI) corrected by TKV and total liver volume (TLV). Method We analyzed 364 patients with ADPKD from the KoreaN Cohort Study for Outcomes in Patients with Chronic Kidney Disease. We compared the changes in TKV in less than 1-year, 2-years and 4-year follow-up from patients by dividing baseline body mass index (BMI) by 18.5 to 22.9 (normal), 23 to 24.9 (overweight), and &gt; 25 kg/m2 (obesity). Results During the 4-year follow-up period, TKV tended to increase statistically with increasing BMI (P = 0.032). Similarly, higher BMI group showed higher TKV than lower BMI group (P = 0.016). Conventional BMI is affected by TKV and TLV in advanced ADPKD patients. Therefore, we reclassified patients by corrected BMI using the adjusted body weight (body weight – TKV – TLV). Although the statistical significances between absolute value of TKV and corrected BMI groups were disappeared during the follow-up, TKV% change/year showed significantly higher in ADPKD patients with obesity among corrected BMI groups (normal; 20.2%, overweight; 17.6% and obesity; 30.6%, P for trend = 0.022) Conclusion Even after correcting the TKV and TVL, obese patients showed a high of TKV% change/year compared to non-obese patients with ADPKD.


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