UTJECAJ ABDOMINALNE DEBLJINE NA VRIJEDNOSTI TLAKA U BOLESNIKA S ESENCIJALNOM HIPERTENZIJOM

ALEKSANDAR JOVANOVIĆ, MARIO LAGANOVIĆ, ŽIVKA DIKA, JELENA KOS, IVAN PEĆIN

Debljina značajno povećava rizik od nastanka kardiovaskularnih bolesti u bolesnika s esencijalnom hipertenzijom. Cilj istraživanja bio je procijenti učestalost pretilosti, mjerene različitim metodama, u bolesnika s esencijalnom hipertenzi­jom, njezin utjecaj na arterijski tlak te odrediti najbolju korelaciju indikatora pretilosti i arterijskog tlaka. U istraživanje je uključeno 88 ispitanika s esencijalnom hipertenzijom, 32 muškarca prosječne dobi 59,4 (±10,4) g. i 56 žena prosječne dobi 62,9 (±8,8). Kod svakog ispitanika izmjereni su tjelesna težina (TT) i visina (TV), opseg struka (OS) te izračunan indeks tjelesne mase (ITM). Arterijski tlak je mjeren živnim tlakomjerom. Bolesnicima s prekomjernom TT smatrani su oni s ITM 25–29,9 kg/m², a pretilima >30 kg/m². Abdominalna pretilost je procijenjena mjerenjem OS. Opseg struka veći od 102 cm za muškarce i 88 cm za žene je smatran pretilošću. Muškarci su imali veće tjelesne proporcije od žena (TT 92,5 (±14,5) : 76,7(±11,5) p<0,001; TV 175,4(±7,4) : 163,4(±5,8) p<0,001) te značajno veći opseg struka (102,4(±12,2) : 94,1(±13,9) p=0,006) a nije nađena razlika u dobi, ITM, kao ni u vrijednostima arterijskog tlaka (p>0,05). Nije zabilježena razlika u broju nereguliranih hipertoničara, broju bolesnika s prekomjernom TT ili pretilih ispitanika (p>0,05). Broj pretilih nije se značajno razlikovao s obzirom na korištene različite metode mjerenja (ITM: M 50%, Ž 37%; opseg struka: M 51%, Ž 54%). Kada su uspoređeni hipertoničari s normalnom TT i pretili, zabilježena je značajna razlika u vrijednostima arterijskog tlaka samo u skupini muškaraca (sistolički tlak (ST) 156(±22,5) : 142(±6,4) p=0,04; dijastolički tlak (DT) 94(±11,6) : 82,5(±6,4) p=0,05). Korelacija pokazatelja pretilosti i arterijskog tlaka pokazala se značajnom za OS samo u skupini muškaraca (ST r=0,33, DT r=0,35, p<0,05). Učestalost debljine ne razlikuje se s obzirom na mjerene indikatore pretilosti. Pretili muškarci imaju veći rizik od povišenih vrijednosti arterijskog tlaka. OS bolje korelira s arterijskim tlakom s obzirom na to daje točniji pokazatelj abdominalne pretilosti.

Summary. Obesity significantly increases the risk for the occurrence of cardiovascular disease in patients with essential hypertension. The aim of the study was to assess the frequency of obesity, measured by different methods, in patients with essential hypertension, its effect on arterial pressure, and to determine the best correlation between indicators of obesity and arterial pressure. The study included 88 patients with essential hypertension, 32 males, mean age 59.4 (±10.4) years, and 56 females, mean age 62.9 (±8.8) years. Body weight (BW) and height (BH), waist circumference (WC), and body mass index (BMI) were measured for each subject. Arterial pressure was determined using mercury sphygmomanometer. Overweight patients were defined as those with BMI 25–29.9 kg/m2, while obese as those with 330 kg/m2. Abdominal obesity was assessed by WC. WC values exceeding 102 cm for men and 88 cm for women indicated obesity. Body measures of male patients were higher than those for women (BW 92.5(±14.5) vs 76.7(±11.5) p<0.001; BH 175.4(±7.4) vs 163.4(±5.8) p<0.001), significantly higher waist circumference values (102.4(±12.2) vs 94.1(±13.9) p=0.006), with no differences in age, BMI, and arterial pressure values (p>0.05). Also, no differences were observed in the number of uncontrolled hyperten- sive patients or number of overweight or obese patients (p>0.05). The number of obese patients did not differ significantly with regard to the various measurement methods employed (BMI: M 50%, F 37%; waist measurement: M 51%, F 54%). A significant difference was noted in arterial pressure values only in the male patient group on comparing patients with normal BW and obese patients (systolic blood pressure (SBP) 156(±22.5) vs 142(±6.4) p=0.04; diastolic blood pressure (DBP) 94(±11.6) vs 82.5(±6.4) p=0.05). The correlation between obesity indicators and arterial pressure was significant for WC only in the male group (SBP r=0.33, DBP r=0.35, p<0.05). The frequency of obesity does not differ with regard to the deter- mined obesity indicators. Obese men have higher risk for increased arterial pressure values. WC values correlate better with arterial pressure values as it is a more accurate indicator of abdominal obesity.