RESUMEN
OBJECTIVE: This study aimed to (1) characterize cardiometabolic factors in self-reported hip and knee osteoarthritis (OAD) across four body composition phenotypes defined by muscle mass and adiposity, and (2) associate risk factors with diabetes and hypertension (HTN). METHODS: A cross-sectional analysis of the Chilean National Health Survey 2016-17 (n = 4996) stratified participants into four groups: low skeletal muscle mass/high waist circumference (Low-SMM/High-WC), low SMM/low WC (Low-SMM/Low-WC), high SMM/high WC (High-SMM/High-WC), and high SMM/low WC (reference group). Each group was further divided into subgroups with or without diagnosed hip or knee OAD. The main outcomes were fasting plasma glucose, systolic (SBP)/diastolic (DBP) blood pressure (continuous outcomes), and other secondary factors such as cardiovascular risk (CVR). RESULTS: In the hip OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (145 vs. 127 mmHg, p < 0.0001, diff +18 mmHg). In the knee OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (141 vs. 134 mmHg, p < 0.0001, diff +7 mmHg). The SBP showed a significant interaction between the group and OAD diagnosis (p = 0.007 hip OAD; p < 0.0001 knee OAD). CONCLUSIONS: Hip and knee OAD associates with elevated SBP/DBP in older adults. OAD groups showed an OR above 2 for diabetes, 2.7 for HTN, 4.5 for metabolic syndrome, and over 2 for moderate-to-high cardiovascular risk. OAD interacts substantially with cardiometabolic factors, especially in low muscle mass/high adiposity phenotypes. Lifestyle optimization of physical activity and nutrition to preserve muscle mass and mitigate adiposity is essential for cardiometabolic health promotion in OAD patients.
Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus , Hipertensión , Osteoartritis de la Cadera , Osteoartritis de la Rodilla , Humanos , Anciano , Adiposidad , Osteoartritis de la Rodilla/epidemiología , Estudios Transversales , Chile/epidemiología , Osteoartritis de la Cadera/epidemiología , Índice de Masa Corporal , Obesidad/complicaciones , Obesidad/epidemiología , Factores de Riesgo , Circunferencia de la Cintura , Presión Sanguínea , Fenotipo , Encuestas EpidemiológicasRESUMEN
BACKGROUND: A progressive volitional cycling test is useful in determining exercise prescription in populations with cardiovascular and metabolic diseases. However, little is known about the association between heart rate during this test and endothelial dysfunction (EDys) parameters in hypertensive (HTN) patients. OBJECTIVE: To investigate the association between EDys markers (flow-mediated dilation [FMD], pulse wave velocity of the brachial artery [PWVba], and carotid-intima media thickness [cIMT]) and heart rate during a cycling test in HTN adults. A secondary aim was to characterize cardiovascular, anthropometric, and body composition outcomes in this population. METHODS: This was a descriptive clinical study in which adults (men and women) were assigned to one of three groups: HTN, elevated blood pressure (Ele), or a normotensive control group (CG), and completed a progressive cycling test. The primary outcomes were FMD, PWVba, cIMT, and heart rate (HR) at 25-50 watts (HR25-50), 50-100 watts (HR50-100), and 75-150 watts (HR75-150) of the Astrand test. Secondary outcomes included body mass index (BMI), waist circumference, body fat percentage (BF%), skeletal muscle mass (SMM), resting metabolic rate (RMR), and estimated body age, as measured by a bio-impedance digital scale. RESULTS: Analyses of the associations between FMD, PWV, and HR25-50, HR50-100, and HR75-150 watts revealed no significant association in the HTN, Ele, and CG groups. However, a significant association was found between cIMT and HR75-150 watts in the HTN group (R2 47.1, ß -0.650, p = 0.038). There was also a significant trend (p = 0.047) towards increasing PWVba in the CG, Ele, and HTN groups. CONCLUSION: Heart rate during a progressive cycling test is associated with the EDys parameters cIMT in HTN patients, with particularly strong predictive capacity for vascular parameters in the second and third stages of the Astrand exercise test compared to normotensive control.