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Title: Resting metabolic rate is increased in hypertensive patients with overweight or obesity: Potential mechanisms
Authors: Pedrianes Martín, Pablo Benito 
Perez-Valera, Mario 
Morales-Alamo, David 
Martin-Rincon, Marcos 
Serrano-Sanchez, Jose A. 
Gonzalez-Henriquez, Juan Jose 
Galvan-Alvarez, Victor 
Acosta, Carmen
Curtelin, David 
de Pablos-Velasco, Pedro 
Calbet, Jose A.L. 
UNESCO Clasification: 241106 Fisiología del ejercicio
Keywords: Exercise
Resting Energy Expenditure
Issue Date: 2021
Project: Viabilidad y sostenibilidad del adelgazamiento mediante tratamiento intensificado en pacientes con sobrepeso u obesidad: mecanismos neuroendocrinos y moleculares 
Integracion de Los Grupos de la Obesidad y El Síndrome Metabólico .... (Estructurante-4.- Campo: Medicina y Salud) 
Estudio longitudinal de los efectos de una modificación intensiva del estilo de vida en la composición corporal e indicadores bioquímicos y moleculares de salud en pacientes con sobrepeso y obesidad: aplicación para la evaluación fisiológica de rutas y sistemas de monitorización del esfuerzo 
Journal: Scandinavian Journal of Medicine and Science in Sports 
Abstract: The purpose of this investigation was to determine whether differences in body composition, pharmacological treatment, and physical activity explain the increased resting metabolic rate (RMR) and impaired insulin sensitivity in hypertension. Resting blood pressure, RMR (indirect calorimetry), body composition (dual-energy X-ray absorptiometry), physical activity (accelerometry), maximal oxygen uptake (VO2max) (ergospirometry), and insulin sensitivity (Matsuda index) were measured in 174 patients (88 men and 86 women; 20–68 years) with overweight or obesity. Hypertension (HTA) was present in 51 men (58%) and 42 women (49%) (p =.29). RMR was 6.9% higher in hypertensives than normotensives (1777 ± 386 and 1663 ± 383 kcal d−1, p =.044). The double product (systolic blood pressure × heart rate) was 18% higher in hypertensive than normotensive patients (p <.001). The observed differences in absolute RMR were non-significant after adjusting for total lean mass and total fat mass (estimated means: 1702 kcal d−1, CI: 1656–1750; and 1660 kcal d−1, CI: 1611–1710 kcal d−1, for the hypertensive and normotensive groups, respectively, p =.19, HTA × sex interaction p =.37). Lean mass, the double product, and age were the variables with the higher predictive value of RMR in hypertensive patients. Insulin sensitivity was lower in hypertensive than in normotensive patients, but these differences disappeared after accounting for physical activity and VO2max. In summary, hypertension is associated with increased RMR and reduced insulin sensitivity. The increased RMR is explained by an elevated myocardial oxygen consumption due to an increased resting double product, combined with differences in body composition between hypertensive and normotensive subjects.
ISSN: 0905-7188
DOI: 10.1111/sms.13955
Source: Scandinavian Journal of Medicine and Science in Sports [ISSN 0905-7188], v. 31 (7), p. 1461-1470, (Junio 2021)
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