Greater leg adiposity may reduce hypertension risk
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A greater proportion of leg adiposity was inversely and independently linked to all subtypes of hypertension in young and middle-aged adults, researchers found.
“There has been literature in the past linking thigh and calf circumferences to decreased insulin resistance and decreased diabetes, so we were not surprised to find that leg fat was protective (even though it does seem counterintuitive),” Aayush Visaria, MPH, fourth-year medical student at Rutgers New Jersey Medical School in Newark, told Healio. “However, we showed and confirmed that this link to hypertension persisted even after taking out the effect of abdominal fat.”
In a study presented at the American Heart Association Hypertension Scientific Sessions, researchers analyzed data from 5,997 patients (mean age, 37 years; 49% women) aged 20 to 59 years who were without a history of CVD and not taking antihypertensive medications. Dual energy X-ray absorptiometry determined the percent of total fat mass in bilateral lower extremities. Patients were then categorized by leg adiposity: low fat (< 34% for men, < 39% for women) or high fat ( 34% for men, 39% for women).
The outcome of interest was hypertension subtype, which included isolated systolic hypertension, isolated diastolic hypertension and systolic-diastolic hypertension. For this study, hypertension was defined as BP greater than 130/80 mm Hg.
Of the patients in this study, 24% had hypertension.
Patients with higher leg fat had lower unadjusted relative odds for isolated systolic hypertension (39%), isolated diastolic hypertension (53%) and systolic-diastolic hypertension (61%). Lower relative odds for these conditions decreased to 24%, 31% and 34%, respectively, after adjusting for covariates.
Higher leg adiposity significantly lowered the relative odds for systolic-diastolic hypertension compared with isolated systolic hypertension when leg adiposity was treated as a continuous variable.
“If these results are confirmed by larger, more robust studies, there is potential for the results to affect patient care,” Visaria said in an interview. “Ultimately, what we are seeing in this study is a continued discussion of ‘it’s not just how much fat you have, but where it is located.’”
Visaria told Healio that more advanced tools are needed to locate fat.
“Although DXA scans are the gold standard of measuring fat and are what we utilized in the study, they are costly and not readily available to the public,” Visaria said. “Until we have more sophisticated tools to help us easily and accurately identify localized fat, it would be difficult to develop protocols/guidelines for this. However, just as waist circumference is used to estimate abdominal fat, thigh circumference may be a useful tool, although a bit cumbersome and not as widely studied in the U.S. population.”
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Visaria A, et al. Presentation MP34. Presented at: American Heart Association Hypertension Scientific Sessions; Sept. 10-13, 2020 (virtual meeting).
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