A greater amount of visceral adiposity may be associated with an increased risk for the development of hypertension, according to a new study published Sept. 1 in the Journal of the American College of Cardiology. 

The study followed 903 patients enrolled in the Dallas Heart Study for an average of seven years to track development of hypertension – classified as systolic blood pressure of greater or equal to 140, diastolic blood pressure of greater or equal to 90, or initiation of blood pressure medications. By the end of the investigation period, 25 percent of the patients developed hypertension. While higher body mass index was significantly associated with incident hypertension, when visceral adipose tissue, subcutaneous adipose tissue, and lower body fat were added to the model, only visceral adipose tissue remained independently associated with incident hypertension.

Further, the "strongest association" was observed with retroperitoneal fat. "The high incidence of hypertension and presence of retroperitoneal fat could suggest that the effects from fat around the kidneys are influencing the development of hypertension," said Aslan T. Turer, MD, MHS, FACC, senior author, and Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX. "This link could open new avenues for the prevention and management of hypertension. The finding of the fat around the kidney is a novel one and we do not know specifically what the 'in the mirror' correlates are."

In a corresponding editorial, Lawrence Krakoff, MD, Cardiovascular Institute, Mount Sinai Medical Center, New York, says that while it is indeed unclear as to whether increased retroperitoneal fat is a cause or result of mechanisms that increase blood pressure associated with obesity, "the possible importance of retroperitoneal adiposity as a predictor of future hypertension implies the need for simple and practical methods to measure this particular fat depot in larger epidemiological surveys, especially when resources are limited. Further analysis of such a well-characterized prospective database provided by the Dallas Heart Study may unmask such methods."

Keywords: Intra-Abdominal Fat, Body Mass Index, Body Composition, Adiposity, Obesity, Hypertension, Subcutaneous Fat