Abdominal obesity is associated with microalbuminuria and an elevated cardiovascular risk profile in patients with hypertension

Martin Thoenes, Jan Christian Reil, Bobby Varkey Khan, Peter Bramlage, Massimo Volpe, Wilhelm Kirch, Michael Böhm

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Background: Overweight and obesity are frequently associated with preventable death and have emerged as a major challenge to public health. There is an ongoing debate on the role of abdominal obesity and its value in predicting cardiovascular and renal outcomes. The present analysis evaluates the prevalence of microalbuminuria (MAU) and conventional cardiovascular risk factors in relation to measures of general and abdominal obesity. Methods: In this multinational, observational study, 20828 hypertensive out-patients from 26 countries including Europe, North and Latin America, Middle East, and Asia were analyzed. Urinary dipstick screening for MAU was performed as well as data on patient demographics, anthropometric measures, cardiovascular risk factors, comorbid conditions, and cardiovascular drug therapy collected. MAU prevalence was determined by a stepwise logistic regression analysis with cardiovascular risk factors as univariate. Results: In the univariate analysis, MAU prevalence systematically increased with body mass index (BMI) from 54.4% (1st tertial) to 62.1% (3rd tertial) (p <0.0001), an increase which was also observed for waist circumference (WC). At any level of BMI, MAU increased with WC from 53.5%, 54.8%, and 55.0% (1st tertial of WC in all three BMI tertials) to 61.4%, 62.1%, and 64.0% (3rd tertial of WC in all BMI tertials) (p <0.0001). In the multivariate analysis, WC, but not BMI was independently associated with MAU. Furthermore, overweight/obesity were associated with the presence of modifiable and nonmodifiable risk factors. Conclusion: An abnormal WC, but not BMI appears to be independently associated with MAU, an early marker of cardiovascular and renal risk. Increasing WC confers an incremental risk for MAU at any level of BMI, underlining the prognostic importance of abdominal fat accumulation beyond general obesity.

Original languageEnglish
Pages (from-to)577-585
Number of pages9
JournalVascular Health and Risk Management
Volume5
Publication statusPublished - 2009

Fingerprint

Abdominal Obesity
Waist Circumference
Body Mass Index
Hypertension
Obesity
Kidney
Cardiovascular Agents
Abdominal Fat
Middle East
Far East
Latin America
North America
Observational Studies
Outpatients
Multivariate Analysis
Public Health
Logistic Models
Regression Analysis
Demography
Drug Therapy

Keywords

  • Abdominal
  • Cardiovascular
  • Microalbuminuria
  • Obesity
  • Renal

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)
  • Public Health, Environmental and Occupational Health
  • Hematology
  • Endocrinology, Diabetes and Metabolism

Cite this

Abdominal obesity is associated with microalbuminuria and an elevated cardiovascular risk profile in patients with hypertension. / Thoenes, Martin; Reil, Jan Christian; Khan, Bobby Varkey; Bramlage, Peter; Volpe, Massimo; Kirch, Wilhelm; Böhm, Michael.

In: Vascular Health and Risk Management, Vol. 5, 2009, p. 577-585.

Research output: Contribution to journalArticle

Thoenes, Martin ; Reil, Jan Christian ; Khan, Bobby Varkey ; Bramlage, Peter ; Volpe, Massimo ; Kirch, Wilhelm ; Böhm, Michael. / Abdominal obesity is associated with microalbuminuria and an elevated cardiovascular risk profile in patients with hypertension. In: Vascular Health and Risk Management. 2009 ; Vol. 5. pp. 577-585.
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AU - Reil, Jan Christian

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AU - Volpe, Massimo

AU - Kirch, Wilhelm

AU - Böhm, Michael

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AB - Background: Overweight and obesity are frequently associated with preventable death and have emerged as a major challenge to public health. There is an ongoing debate on the role of abdominal obesity and its value in predicting cardiovascular and renal outcomes. The present analysis evaluates the prevalence of microalbuminuria (MAU) and conventional cardiovascular risk factors in relation to measures of general and abdominal obesity. Methods: In this multinational, observational study, 20828 hypertensive out-patients from 26 countries including Europe, North and Latin America, Middle East, and Asia were analyzed. Urinary dipstick screening for MAU was performed as well as data on patient demographics, anthropometric measures, cardiovascular risk factors, comorbid conditions, and cardiovascular drug therapy collected. MAU prevalence was determined by a stepwise logistic regression analysis with cardiovascular risk factors as univariate. Results: In the univariate analysis, MAU prevalence systematically increased with body mass index (BMI) from 54.4% (1st tertial) to 62.1% (3rd tertial) (p <0.0001), an increase which was also observed for waist circumference (WC). At any level of BMI, MAU increased with WC from 53.5%, 54.8%, and 55.0% (1st tertial of WC in all three BMI tertials) to 61.4%, 62.1%, and 64.0% (3rd tertial of WC in all BMI tertials) (p <0.0001). In the multivariate analysis, WC, but not BMI was independently associated with MAU. Furthermore, overweight/obesity were associated with the presence of modifiable and nonmodifiable risk factors. Conclusion: An abnormal WC, but not BMI appears to be independently associated with MAU, an early marker of cardiovascular and renal risk. Increasing WC confers an incremental risk for MAU at any level of BMI, underlining the prognostic importance of abdominal fat accumulation beyond general obesity.

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