T Nation

Hypertension and BMI

The question of the relationship between BMI due to increased muscle mass and cardiovascular disease came up over on the Underground and I thought it bore posting over here. Hopefully this will provoke some discussion.

There is extremely limited data on cardiovascular disease and BMI in athletes. Logically, increased BMI means the heart is going to work harder (more stuff to drive blood through)- and we know that the heart working harder makes it grow (i.e. hypertension leads to left ventricular hypertrophy). Whether a normotensive individual with elevated BMI and reasonable BF% is at risk for cardiovascular disease is unclear.

A quick look through Pubmed reveals the following abstracts. The echocardiographic survey of sumo wrestlers shows a high prevelance of left ventricular hypertrophy in non-hypertensive sumo wrestlers, implying that increased BMI alone may be a risk factor for LVH. I’ll need to look at the full paper on steroids, bodybuilders, and LVH to see if the non-drug using bodybuilders with similar BMI had LVH.

At this point (as a powerlifting MD weighting 250), my advice to you would be to try to drop some excess fat if you can, keep up with your cardio, and don’t be shy about starting antihypertensives if your pressure is persistantly over 130/80.

Sci Med Sport. 2003 Dec;6(4)379-86. Related Articles, Links

Recognition of left ventricular hypertrophy in new recruits of professional sumo wrestling.

Kinoshita N, Onishi S, Yamazaki H, Katsukawa F, Yamada K.

Influence of systolic blood pressure and body mass index on left ventricular structure in healthy African-American and white young adults: the CARDIA study.

Lorber R, Gidding SS, Daviglus ML, Colangelo LA, Liu K, Gardin JM.

Department of Pediatrics at the Cleveland Clinic, Cleveland, Ohio, USA.

OBJECTIVES: In the Coronary Artery Risk Development in Young Adults (CARDIA) Study comprised of a generally healthy, biracial cohort of 28- to 40-year-old adults, we sought to characterize the distribution of left ventricular (LV) mass and LV geometry and the relationship of systolic blood pressure (SBP), body mass index (BMI), and fasting insulin to LV mass and geometry. BACKGROUND: Left ventricular mass is a risk factor for cardiovascular morbidity and mortality. METHODS: Two-dimensionally guided M-mode echocardiograms were used to calculate LV mass index (g/height(2.7)) and geometry. RESULTS: Black men had highest LV mass index followed by white men, black women, and white women. Blacks had higher LV wall thickness/diameter ratios than whites. Left ventricular hypertrophy was present in 2% of the cohort. Going from highest to lowest quartile for LV mass index and LV wall thickness/diameter ratio, SBP and BMI were highest in those with the highest LV mass index and LV wall thickness/diameter ratio. Increasing BMI and SBP over a 10-year interval was also strongly related to LV structure in most race/gender groups. CONCLUSIONS: In a generally healthy young adult cohort, LV structure as defined by LV mass and geometry is associated with SBP and BMI at levels generally considered normal.

Sports Medicine Research Center, Keio University, Yokohama, Japan.

The efficacy of electrocardiography (ECG) in the diagnosis of left ventricular (LV) hypertrophy in 890 males, newly recruited to Japanese professional sumo wrestling (15.9 +/- 1.8 years of age, 177.8 +/- 4.7cm, 107.3 +/- 4.7kg), was tested by comparing simple, widely employed ECG criteria (Sokolow-Lyon chest and limb lead voltages and Cornell voltage with repolarisation criteria) with echocardiographic evaluations of LV mass indexed to body surface area. LV hypertrophy was defined as a LV mass index > 2 SD above the mean value obtained from 115 age-matched, normotensive, sedentary, male controls. The prevalence of LV hypertrophy as determined by echocardiography was 9.0% the entire group and was 8.3% among the 484 normotensives. The sensitivities of the three ECG criteria were or = 36.0%, and their specificities were 70.0-99.0%. In contrast to the Sokolow-Lyon chest lead criteria, the diagnostic performance of the Cornell criteria was little affected by body mass index (BMI), and stepwise regression revealed that BMI did not significantly correlate with Cornell voltage. Still, the diagnostic efficacy of ECG was not sufficient to merit its use for primary recognition of LV hypertrophy among professional sumo wrestlers. Indeed, LV hypertrophy will likely go

Clin J Sport Med. 1997 Apr;7(2):90-3. Related Articles, Links

Left ventricular size and function in elite bodybuilders using anabolic steroids.

Dickerman RD, Schaller F, Zachariah NY, McConathy WJ.

Department of Biochemistry & Molecular Biology, University of North Texas Health Science Center, Fort Worth 76107-2609, USA.

OBJECTIVE: To investigate the relationship between resistance training, anabolic steroid use, and left ventricular function. DESIGN: Sixteen competitive bodybuilders were recruited for an echocardiography study. SETTING: University of North Texas Health Science Center (Fort Worth, TX, U.S.A.); the cardiologist and technician were blinded as to subjects’ drug status. SUBJECTS: Eight competitive heavyweight drug-free (DF) bodybuilders and eight competitive heavyweight body-builders on self-directed regimens of anabolic steroids. RESULTS: Average body mass indexes (BMI; kg/m2) for the drug-user (DU) and DF groups were not significantly different (34.1 +/- 2.8 and 32.0 +/- 4.3, respectively). Increases in left ventricular posterior wall and ventricular septal thickness were apparent in the DU group (p < 0.05). The ratio of echocardiographic findings to BMI revealed a significantly smaller left ventricular end-diastolic dimension (LVDEd/BMI; p 0.05) in the DU group. The smaller LVDEd in DUs is coupled with a significantly disproportionate septal and posterior wall thickness in DUs when indexed to body mass compared to DFs. There was no direct evidence of diastolic dysfunction detected by mitral inflow velocity patterns. CONCLUSION: Anabolic steroids may potentiate concentric left ventricular hypertrophy with decreasing ventricular compliance without affecting cardiac function.

PMID: 9113423 [PubMed - indexed for MEDLINE]