Dysfonction diastolique, rigidité artérielle aortique et hypertension : facteurs anthropométriques et métaboliques associés et prise en charge en population générale

Abstract : Worldwide increasing obesity over the last decades expose the population to an increased risk of metabolic perturbations and cardiovascular diseases. This research investigated first the association of obesity with diastolic dysfunction and aortic stiffness observed 20 years later in initially healthy adults. General obesity measured with body mass index and abdominal adiposity measured with waist circumference were positively associated with diastolic dysfunction. But, these anthropometric parameters played a protective role in aortic stiffness. The ratio “waist circumference / body mass index” appeared to better isolate abdominal adiposity from general obesity and was then positively associated with aortic stiffness. It allowed to evidence a harmful role of abdominal adiposity in aortic stiffness, even in subjects with normal body weight. The presence of abdominal adiposity (measured with waist circumference) combined with an elevated level of triglycerides was associated with a higher risk of diastolic dysfunction. In the second part, our research focused on hypertensive individuals. It showed that among hypertensive subjects, those having undiagnosed-hypertension had specific features (being more often male, having less elevated waist circumference, and having fewer cardiovascular diseases/diabetes, familial hypertension history, and primary care uses). The concomitant presence of a higher number of these criteria appeared to strongly reinforce the absence of diagnosis. Our findings may help to early identify subjects at risk, and to establish prevention and therapeutic management.
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Kénora Chau. Dysfonction diastolique, rigidité artérielle aortique et hypertension : facteurs anthropométriques et métaboliques associés et prise en charge en population générale. Santé publique et épidémiologie. Université de Lorraine, 2018. Français. ⟨NNT : 2018LORR0281⟩. ⟨tel-02109632⟩

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