Impact of Excess Body Weight on Arterial Structure, Function, and Blood Pressure in Firefighters

Published:September 28, 2009DOI:
      Cardiovascular disease is the leading cause of death among firefighters. The purpose of the present study was to examine the effect of excess body weight on arterial structure and function and blood pressure (BP) in relatively young, apparently healthy, firefighters. The body mass index, brachial BP, carotid BP, aortic BP, radial augmentation index, central pulse wave velocity, forearm blood flow, forearm vasodilatory capacity, carotid arterial compliance, carotid intima-media thickness, and brachial flow-mediated dilation were assessed in 110 firefighters (aged 29.7 ± 8.0 years). The group was divided into equal tertiles according to the body mass index (<25.9, 25.9 to 29.4, and ≥29.5 kg/m2). Group differences in hemodynamics, anthropometrics, microvascular function, and macrovascular structure and function were tested using multivariate analysis of variance. The obese group was older, heavier, and had a larger waist circumference compared to the lean and overweight groups (p <0.05). The overweight group was also older, heavier, and had a larger waist circumference than the lean group (p <0.05). Compared to the lean group, the overweight and obese groups had a greater systolic BP (p <0.05). The obese group also had a significantly greater mean arterial BP and carotid systolic BP than the lean group (p <0.05). The obese group had greater β stiffness and elastic modulus compared to the lean and overweight groups (p <0.05), but no group differences were found in endothelial function. In conclusion, in a population of relatively young firefighters, an increased body mass index was associated with elevated peripheral BP and arterial stiffness, with no apparent decrements in endothelial function.
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        • Laurent S.
        • Boutouyrie P.
        • Asmar R.
        • Gautier I.
        • Laloux B.
        • Guize L.
        • Ducimetiere P.
        • Benetos A.
        Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients.
        Hypertension. 2001; 37: 1236-1241
        • Verma S.
        • Buchanan M.R.
        • Anderson T.J.
        Endothelial function testing as a biomarker of vascular disease.
        Circulation. 2003; 108: 2054-2059
        • Agabiti-Rosei E.
        • Mancia G.
        • O'Rourke M.F.
        • Roman M.J.
        • Safar M.E.
        • Smulyan H.
        • Wang J.G.
        • Wilkinson I.B.
        • Williams B.
        • Vlachopoulos C.
        Central blood pressure measurements and antihypertensive therapy: a consensus document.
        Hypertension. 2007; 50: 154-160
        • Pruissen D.M.
        • Gerritsen S.A.
        • Prinsen T.J.
        • Dijk J.M.
        • Kappelle L.J.
        • Algra A.
        Carotid intima-media thickness is different in large- and small-vessel ischemic stroke: the SMART study.
        Stroke. 2007; 38: 1371-1373
        • Weber T.
        • Auer J.
        • O'Rourke M.F.
        • Kvas E.
        • Lassnig E.
        • Berent R.
        • Eber B.
        Arterial stiffness, wave reflections, and the risk of coronary artery disease.
        Circulation. 2004; 109: 184-189
        • Fernhall B.
        • Agiovlasitis S.
        Arterial function in youth: window into cardiovascular risk.
        J Appl Physiol. 2008; 105: 325-333
        • Heffernan K.S.
        • Jae S.Y.
        • Wilund K.R.
        • Woods J.A.
        • Fernhall B.
        Racial differences in central blood pressure and vascular function in young men.
        Am J Physiol Heart Circ Physiol. 2008; 295: H2380-H2387
        • Soteriades E.S.
        • Hauser R.
        • Kawachi I.
        • Liarokapis D.
        • Christiani D.C.
        • Kales S.N.
        Obesity and cardiovascular disease risk factors in firefighters: a prospective cohort study.
        Obes Rev. 2005; 13: 1756-1763
      1. Tsismenakis AJ, Christophi CA, Burress JW, Kinney AM, Kim M, Kales SN. The obesity Epidemic and future emergency responders. Obesity Epub 2009 March 9; doi: 10.1038/oby.2009.63 .

        • Pauca A.L.
        • O'Rourke M.F.
        • Kon N.D.
        Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform.
        Hypertension. 2001; 38: 932-937
        • Wilkinson I.B.
        • MacCallum H.
        • Flint L.
        • Cockcroft J.R.
        • Newby D.E.
        • Webb D.J.
        The influence of heart rate on augmentation index and central arterial pressure in humans.
        J Physiol. 2000; 525: 263-270
        • Van Bortel L.M.
        • Duprez D.
        • Starmans-Kool M.J.
        • Safar M.E.
        • Giannattasio C.
        • Cockcroft J.
        • Kaiser D.R.
        • Thuillez C.
        Clinical applications of arterial stiffness, Task Force III: recommendations for user procedures.
        Am J Hypertens. 2002; 15: 445-452
        • Higashi Y.
        • Sasaki S.
        • Nakagawa K.
        • Matsuura H.
        • Kajiyama G.
        • Oshima T.
        A noninvasive measurement of reactive hyperemia that can be used to assess resistance artery endothelial function in humans.
        Am J Cardiol. 2001; 87: 121-125
        • Kannel W.B.
        • Wolf P.A.
        • McGee D.L.
        • Dawber T.R.
        • McNamara P.
        • Castelli W.P.
        Systolic blood pressure, arterial rigidity, and risk of stroke: the Framingham study.
        JAMA. 1981; 245: 1225-1229
        • Vergnaud A.C.
        • Protogerou A.D.
        • Blacher J.
        • Safar M.E.
        From “optimal” to “borderline” blood pressure in subjects under chronic antihypertensive therapy.
        J Hypertens. 2008; 26: 138-144
        • Protogerou A.D.
        • Papaioannou T.G.
        • Blacher J.
        • Papamichael C.M.
        • Lekakis J.P.
        • Safar M.E.
        Central blood pressures: do we need them in the management of cardiovascular disease?.
        J Hypertens. 2007; 25: 265-272
        • Danchin N.
        • Benetos A.
        • Lopez-Sublet M.
        • Demicheli T.
        • Safar M.
        • Mourad J.J.
        Aortic pulse pressure is related to the presence and extent of coronary artery disease in men undergoing diagnostic coronary angiography: a multicenter study.
        Am J Hypertens. 2004; 17: 129-133
        • Jankowski P.
        • Kawecka-Jaszcz K.
        • Bryniarski L.
        • Czarnecka D.
        • Brzozowska-Kiszka M.
        • Posnik-Urbanska A.
        • Kopec G.
        • Dragan J.
        • Klecha A.
        • Dudek D.
        Fractional diastolic and systolic pressure in the ascending aorta are related to the extent of coronary artery disease.
        Am J Hypertens. 2004; 17: 641-646
        • Geibe J.R.
        • Holder J.
        • Peeples L.
        • Kinney A.M.
        • Burress J.W.
        • Kales S.N.
        Predictors of on-duty coronary events in male firefighters in the United States.
        Am J Cardiol. 2008; 101: 585-589
        • Kales S.N.
        • Soteriades E.S.
        • Christoudias S.G.
        • Christiani D.C.
        Firefighters and on-duty deaths from coronary heart disease: a case control study.
        Environ Health. 2003; 2: 14
        • Guidotti T.L.
        Occupational mortality among firefighters: assessing the association.
        J Occup Environ Med. 1995; 37: 1348-1356
        • Blacher J.
        • Asmar R.
        • Djane S.
        • London G.M.
        • Safar M.E.
        Aortic pulse wave velocity as a marker of cardiovascular risk in hypertensive patients.
        Hypertension. 1999; 33: 1111-1117
        • Jourdan C.
        • Wuhl E.
        • Litwin M.
        • Fahr K.
        • Trelewicz J.
        • Jobs K.
        • Schenk J.P.
        • Grenda R.
        • Mehls O.
        • Troger J.
        • Schaefer F.
        Normative values for intima-media thickness and distensibility of large arteries in healthy adolescents.
        J Hypertens. 2005; 23: 1707-1715
        • Giannattasio C.
        • Capra A.
        • Facchetti R.
        • Viscardi L.
        • Bianchi F.
        • Failla M.
        • Colombo V.
        • Grieco A.
        • Mancia G.
        Relationship between arterial distensibility and coronary atherosclerosis in angina patients.
        J Hypertens. 2007; 25: 593-598
        • Cheung YF O.K.
        • Woo C.W.
        • Armstrong S.
        • Siow Y.L.
        • Chow P.C.
        • Cheung E.W.
        Oxidative stress in children late after Kawasaki disease: relationship with carotid atherosclerosis and stiffness.
        BMC Pediatr. 2008; 8: 20
        • Mannion T.C.
        • Vita J.A.
        • Keaney Jr, J.F.
        • Benjamin E.J.
        • Hunter L.
        • Polak J.F.
        Non-invasive assessment of brachial artery endothelial vasomotor function: the effect of cuff position on level of discomfort and vasomotor responses.
        Vasc Med. 1998; 3: 263-267
        • Verma S.
        • Wang C.H.
        • Lonn E.
        • Charbonneau F.
        • Buithieu J.
        • Title L.M.
        • Fung M.
        • Edworthy S.
        • Robertson A.C.
        • Anderson T.J.
        Cross-sectional evaluation of brachial artery flow-mediated vasodilation and C-reactive protein in healthy individuals.
        Eur Heart J. 2004; 25: 1754-1760
        • Arkin J.M.
        • Alsdorf R.
        • Bigornia S.
        • Palmisano J.
        • Beal R.
        • Istfan N.
        • Hess D.
        • Apovian C.M.
        • Gokce N.
        Relation of cumulative weight burden to vascular endothelial dysfunction in obesity.
        Am J Cardiol. 2008; 101: 98-101
        • Brook R.D.
        • Bard R.L.
        • Rubenfire M.
        • Ridker P.M.
        • Rajagopalan S.
        Usefulness of visceral obesity (waist/hip ratio) in predicting vascular endothelial function in healthy overweight adults.
        Am J Cardiol. 2001; 88: 1264-1269
      2. Parikh NI, Keyes MJ, Larson MG, Pou KM, Hamburg NM, Vita JA, O'Donnell CJ, Vasan RS, Mitchell GF, Hoffmann U, Fox CS, Benjamin EJ. Visceral and subcutaneous adiposity and brachial artery vasodilator function. Obesity Epub 2009 March 12; doi:10.1038/oby.2009.60 .