Author + information
- Alvin Chandra, MD and
- Aslan T. Turer, MD, MHS∗ ()
- ↵∗Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9047
We thank Dr. Gómez-Ambrosi and colleagues for their insights regarding our paper (1). We agree completely with the notion that body mass index (BMI) has limitations with regard to measuring adiposity, although it certainly remains the most clinically used measure of adiposity. For this reason, we believed it was an important component to add to our multivariate modeling.
As suggested, we did have access to data on total body fat as measured by dual-energy x-ray absorptiometry; however, because this is not a commonly used measure of total adiposity, we did not choose to use it in our multivariate modeling. Nonetheless, total fat mass determined by dual-energy x-ray absorptiometry was, like body mass index, found to be highly associated with the development of hypertension after adjusting for age, baseline systolic blood pressure, sex, race/ethnicity, history of smoking, and diabetes mellitus (relative risk [RR]: 1.27; 95% confidence interval [CI]: 1.14 to 1.41; p < 0.0001). However, as in the original analysis, this association is attenuated when visceral adipose tissue is included in the model (RR: 1.20; 95% CI: 0.89 to 1.62; p = 0.24) while visceral adipose tissue remains significant (RR: 1.20; 95% CI: 1.04 to 1.39; p = 0.012). Thus, despite the addition of a more accurate measure of total adipose mass, our conclusion appears to remain the same, namely that visceral adipose tissue is the adipose tissue depot most associated with incident hypertension.
- American College of Cardiology Foundation