Hemoglobin A1c and C-reactive protein are independently associated with blunted nocturnal blood pressure dipping in obesity-related prediabetes

Abbi D Lane-Cordova; Graziela Z Kalil; Christopher J Wagner; Amy L Sindler; Jess G Fiedorowicz; Tiwaloluwa Ajibewa; William G Haynes; Gary L Pierce

doi:10.1038/hr.2017.82

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Hemoglobin A1c and C-reactive protein are independently associated with blunted nocturnal blood pressure dipping in obesity-related prediabetes

Journal article

Peer reviewed

Hemoglobin A1c and C-reactive protein are independently associated with blunted nocturnal blood pressure dipping in obesity-related prediabetes

Abbi D Lane-Cordova, Graziela Z Kalil, Christopher J Wagner, Amy L Sindler, Jess G Fiedorowicz, Tiwaloluwa Ajibewa, William G Haynes and Gary L Pierce

Hypertension research, Vol.41(1), pp.33-38

01/2018

DOI: 10.1038/hr.2017.82

PMCID: PMC5836467

PMID: 29070829

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https://www.ncbi.nlm.nih.gov/pmc/articles/5836467View

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Abstract

Blunted nocturnal dipping in blood pressure (BP) is associated with increased cardiovascular disease (CVD) risk in middle-aged/older adults. The prevalence of blunted nocturnal BP dipping is higher in persons with obesity and diabetes, conditions that are also associated with elevated aortic stiffness and inflammation. Therefore, we hypothesized that elevated glycemia, inflammation and aortic stiffness would be inversely associated with the magnitude of nocturnal systolic BP dipping among middle-aged/older adults with obesity at high CVD risk. Twenty-four hour ambulatory BP monitoring, aortic stiffness (carotid-femoral pulse wave velocity, CF-PWV), hemoglobin A1c (HbA1c) and inflammation (C-reactive protein, CRP) were measured in 86 middle-aged/older adults with obesity and at least one other CVD risk factor (age 40-74 years; 34 male/52 female; body mass index=36.7±0.5 kg m ; HbA1c=5.7±0.04%). In the entire cohort, CRP (β=0.40±0.20, P=0.04), but not HbA1c or CF-PWV was independently associated with systolic BP dipping percent (Model R =0.07, P=0.12). In stratified (that is, presence or absence of prediabetes) multiple linear regression analysis, HbA1c (β=6.24±2.6, P=0.02) and CRP (β=0.57±0.2, P=0.01), but not CF-PWV (β=0.14± 2.6, P=0.74), were independently associated with systolic BP dipping percent (Model R =0.32, P<0.01) in obese adults with prediabetes but were absent in obese adults without prediabetes (Model R =0.01 P=0.95). However, nocturnal systolic BP dipping percent (P=0.65), CF-PWV (P=0.68) and CRP (P=0.59) were similar between participants with and without prediabetes. These data suggest that impaired long-term glycemic control and higher inflammation may contribute partly to blunted BP dipping in middle-aged/older adults with obesity-related prediabetes.

Body Mass Index

Prediabetic State - blood

Cross-Sectional Studies

Obesity - complications

Glycated Hemoglobin A - metabolism

Humans

Middle Aged

Male

Obesity - physiopathology

Circadian Rhythm - physiology

Obesity - blood

C-Reactive Protein - metabolism

Prediabetic State - physiopathology

Vascular Stiffness - physiology

Adult

Female

Aged

Blood Pressure - physiology

Blood Glucose - metabolism

Blood Pressure Monitoring, Ambulatory

Prediabetic State - etiology

Details

Title: Subtitle: Hemoglobin A1c and C-reactive protein are independently associated with blunted nocturnal blood pressure dipping in obesity-related prediabetes
Creators: Abbi D Lane-Cordova - Department of Exercise Science, Arnold College of Public Health, University of South Carolina, Columbia, SC, USA
Graziela Z Kalil - Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
Christopher J Wagner - Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
Amy L Sindler - Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
Jess G Fiedorowicz - Abboud Cardiovascular Research Cente
Tiwaloluwa Ajibewa - Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
William G Haynes - Abboud Cardiovascular Research Cente
Gary L Pierce - Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Hypertension research, Vol.41(1), pp.33-38
DOI: 10.1038/hr.2017.82
PMID: 29070829
PMCID: PMC5836467
NLM abbreviation: Hypertens Res
ISSN: 0916-9636
eISSN: 1348-4214
Publisher: England
Grant note: P01 HL014388 / NHLBI NIH HHS P30 ES005605 / NIEHS NIH HHS U54 TR001356 / NCATS NIH HHS T32 HL007121 / NHLBI NIH HHS R21 AG043722 / NIA NIH HHS
Language: English
Date published: 01/2018
Academic Unit: Psychiatry; Epidemiology; Health, Sport, and Human Physiology ; Internal Medicine
Record Identifier: 9984002491502771

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