Hypertension: Long-term obesity and middle-aged carotid intimal-middle membrane thickness are associated through intermediate risk factors

Increased arterial wall thickness is a surrogate marker of early atherosclerosis and is associated with
cardiovascular morbidity and mortality.
Ultrasound non-invasive measurement of carotid intimal-middle membrane thickness (cIMT) has been widely used to assess cardiovascular risk
.
Recently, a research article was published in the cardiovascular authority journal Hypertension, which aims to quantitatively determine the mediating effect
of multiple cardiovascular risk factors on the association between body mass index (BMI) and its cumulative burden in children and carotid intimal-middle membrane thickness (cIMT) in adults.

The longitudinal cohort consisted of 1391 adults who underwent an average of 4-15 BMI tests from childhood to 35.
0 years of age, with data
on adult cIMT, systolic blood pressure, LDL cholesterol, plasma atherogenic index, and blood glucose.
The area under the curve is used to measure the cumulative burden
of BMI.

After adjusting for covariates, the total effects (standardized regression coefficients) of BMI (0.
138), adult BMI (0.
111) and area under the BMI curve (0.
150) on cIMT were significant (P<0.
001), and no mediators
were added to the model.
In the childhood BMI prediction model, the mediated effects of systolic blood pressure, glucose, plasma atherogenic index and LDL cholesterol in adults were 8.
0%, 4.
3%, 3.
6% and 0.
0%,
respectively.
In the adult BMI prediction model, the mediated effects of systolic blood pressure, blood glucose, plasma atherogenic index and LDL cholesterol in adults were 23.
4%, 15.
3%, 12.
6% and 7.
2%,
respectively.
In the prediction model of the area under the BMI curve, the mediated effects of systolic blood pressure, blood glucose and LDL cholesterol in adults were 14.
7%, 8.
7%, 6.
0% and 2.
0%,
respectively.
The direct effect of BMI on cIMT was 0.
117 (P<0.
001) in children, 0.
046 (P=0.
224) in adults, and the area under the BMI curve after removing mediated effects was 0.
103 (P<0.
001).

It can be seen that the long-term harmful effects of obesity on subclinical changes in vascular structure begin early in life and accumulate
throughout life.
Obesity and high cIMT are partly associated with other cardiovascular risk factors later in life, particularly elevated blood pressure and blood sugar
.

Original source:

Tao Zhang.
et al.
Long-Term Adiposity and Midlife Carotid Intima-Media Thickness Are Linked Partly Through Intermediate Risk Factors.
Hypertension.
2022.
HYPERTENSIONAHA.
122.
20217