YIA 02-04 RELATIONSHIP BETWEEN LEPTIN AND INCIDENT HYPERTENSION; OBSERVATIONS FROM THE DALLAS HEART STUDY.

OBJECTIVE: To examine the effect of body adiposity on relationship between leptin and incident hypertension in a multiethnic sample of US population.

DESIGN AND METHOD: Participants were normotensive adults with BP ≤ 130/85 enrolled in Dallas Heart Study, a large, multiethnic population-based cohort. Incident hypertension was defined as systolic BP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or initiation of antihypertensive medications.Biomarkers were measured at baseline from fasting venous blood samples. Retroperitoneal (RP), intraperitoneal (IP), visceral adipose tissue (VAT = IP + RP) and abdominal subcutaneous adipose tissue (SAT) were assessed by magnetic resonance imaging. Liver fat content was measured by 1H-magnetic resonance spectroscopy. Relative risk regression was conducted to determine the relative risk of incident hypertension per 1-SD change of leptin after adjustment for age, race, sex, smoking, diabetes, baseline systolic BP, total cholesterol, HDL cholesterol, hs-CRP, and NT- proBNP.

RESULTS: Among 1,233 initially normotensive participants (median age, 40 years; 56% women; 40% black), 391 (32%) had developed hypertension after a median follow up of 7 years. The significant association between leptin and incident hypertension in the unadjusted model was eliminated after adjusting for BMI or various fat depots (Table and Figure).

CONCLUSIONS: The relationship between leptin and incident hypertension was totally mediated by body adiposity suggesting an adiposity dependent relationship bwtween leptin and blood pressure.