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Mechanisms underlying elevated SBP differ with adiposity in young adults the Enigma study

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posted on 2023-02-06, 13:51 authored by Jessica Middlemiss, Karen L. Miles, Barry McDonnell, Yasmin, Kaisa M. Mäki-Petäjä, John Cockcroft, Ian B. Wilkinson, Carmel M. McEniery

 The positive association between adiposityand hypertensioniswell recognized. However, not all overweight individuals have elevated blood pressure (BP). Moreover, different factors may be associated with high BPin normal-weightversus overweight individuals. The aim of the current study was to examine the influence of adiposityon the relationship between systolic BP(SBP)and underlying haemodynamic mechanisms in young adults.Data from 2502subjects were available from The EnigmaStudy. Detailed demographic, biochemical and haemodynamic data were obtained in all individuals. Data were analyzedbetween lower and upper tertiles ofbody mass index (BMI)and SBP, separately for each gender.In normal-weight individuals, cardiac output (CO) was elevated in those with higherSBP,independently of body size. Moreover,higher CO was associated with an increased stroke volume in males (p<0.001), but an increased heart rate in females (p=0.002). In contrast, in overweight individuals, peripheral vascular resistance (PVR)was elevated in males with higherSBP (p=0.02) and those with lowerSBP 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 SBPand PVRin overweight individuals.Different haemodynamic mechanisms are associated with elevated SBPin young adults, depending on body sizeand gender. These data suggest the need for differential approachesto the identification and management of young adults with elevated BP


This work was funded by the British Heart Foundation and the NIHR Cambridge Biomedical Research Centre


Published in

Journal of Hypertension


Lippincott, Williams & Wilkins


  • VoR (Version of Record)


Middlemiss, 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.

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Cardiff Met Affiliation

  • Cardiff School of Sport and Health Sciences

Cardiff Met Authors

Barry McDonnell John Cockcroft

Cardiff Met Research Centre/Group

  • Cardiovascular Physiology

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  • © The Authors


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