MANY FACTORS CAN AFFECT THE PREVALENCE OF HYPERTENSION IN OBESE PATIENTS - ROLE OF CUFF SIZE AND TYPE OF OBESITY

Objective. To determine to what extent methodological errors, includin g measurements taken with inappropriate cuffs and/or inaccuracies in p atient enrollment, can contribute to overestimating the prevalence of hypertension in overweight or obese women. Experimental design. Random ized and comparative investigation in overweight or obese outpatient w omen of the Obesity Clinic, Internal Medicine Institute, Chieti Univer sity. Patients. In 1,791 overweight or obese women, randomly selected and stratified by age (41-60 years), blood pressure (BP) was taken wit h casual measurement in the morning, The entire study group was divide d into two subgroups, In the first one, casual BP was measured with a standard-size cuff(RCS), while an appropriate large-size cuff was used for the second one (LCS), Patients of the latter subgroup were also d ivided by type of obesity (android and gynoid), based on their waist-t o-hip ratio. Results, In the LCS subgroup, the hypertension prevalence rate was strikingly lower among overweight and obese women, as well a s in the younger and older age groups, when compared with the correspo nding RCS subgroups (p < 0.001). The hypertension prevalence rate was higher for all android obese subjects (53%), including younger (34%) a nd older (64%) groups, when compared with gynoid obese patients (29%, 18% and 42%, respectively). Conclusions. A comparison of different rep orts on the prevalence of hypertension in obesity reveals considerable differences, due mainly to age, sex, race and income level, Neverthel ess, our data seem to indicate that even after adjusting for the above -mentioned variables, two significant confounding factors, cuff hypert ension and the prevalence of android obesity in the obese study popula tion, could be responsible for overestimating the prevalence of hypert ension, It should be noted that for certain groups of overweight and o bese women, the prevalence of hypertension becomes similar to the rate found among the general population, as reported in many large epidemi ological surveys.