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dc.contributor.authorHickson, Stacey S.
dc.contributor.authorNichols, Wilmer W.
dc.contributor.authorMcDonnell, Barry
dc.contributor.authorCockcroft, John R.
dc.contributor.authorWilkinson, Ian B.
dc.contributor.authorMcEniery, Carmel M.
dc.identifier.citationMiddlemiss, J.E., Miles, K.L., McDonnell, B.J., Yasmin, Maki-Petaja, K.M., Cockroft, J.R., Wilkinson, I.B. and McEniery, C.M. (2016) 'Mechanisms underlying elevated systolic blood pressure differ with adiposity in young adults: the Enigma Study', Journal of Hypertension 34 (2), pp. 290-297.en_US
dc.identifier.otherESSN 2167-1095
dc.descriptionThis article was published in Journal of Hypertension in February 2016, available open access at
dc.description.abstractObjectives: The positive association between adiposity and hypertension is well recognized. However, not all overweight individuals have elevated blood pressure (BP). Moreover, different factors may be associated with high BP in normal-weight versus overweight individuals. The aim of the current study was to examine the influence of adiposity on the relationship between SBP and underlying haemodynamic mechanisms in young adults. Method: Data from 2502 patients were available from the Enigma study. Detailed demographic, biochemical, and haemodynamic data were obtained in all individuals. Data were analysed between lower and upper tertiles of BMI and SBP, separately for each sex. Results: In normal-weight individuals, cardiac output (CO) was elevated in those with higher SBP, independently of body size. Moreover, higher CO was associated with an increased stroke volume in men (P < 0.001), but an increased heart rate in women (P = 0.002). In contrast, in overweight individuals, peripheral vascular resistance (PVR) was elevated in men with higher SBP (P = 0.02) and those with lower SBP had the lowest PVR of all groups. In linear regression analyses, there was a stronger association between SBP and CO in normal-weight individuals, but a stronger association between SBP and PVR in overweight individuals. Conclusion: Different haemodynamic mechanisms are associated with elevated SBP in young adults, depending on body size and sex. These data suggest the need for differential approaches to the identification and management of young adults with elevated BP.en_US
dc.description.sponsorshipThis work was funded by the British Heart Foundation and the NIHR Cambridge Biomedical Research Centreen_US
dc.publisherLippincot, Williams & Wilkinsen_US
dc.relation.ispartofseriesJournal of Hypertension
dc.rightsCreative Commons Attribution License
dc.subjectcardiac outputen_US
dc.subjectperipheral vascular resistanceen_US
dc.titleMechanisms underlying elevated systolic blood pressure differ with adiposity in young adults: The Enigma Studyen_US

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