DOI: 10.33631/sabd.1939858 ISSN: 2792-0542

Blood Pressure Variability, Heart Rate Variability Parameters, and ECG Repolarization Parameters in Overweight and Obese Young Adults: Determining the Relationships

Metin Karayakalı, Kayihan Karaman, Gülşen Genç Tapar, Veli Akin, Elif Alçik, Gökhan Cabri
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Aim: Obesity leads to adverse changes in cardiovascular electrophysiology; however, data comparing overweight and obese young individuals are limited. In this study, ventricular repolarization, cardiac autonomic function, and 24-hour blood pressure (ABPM) were compared between two groups, and the aim was to identify factors independently associated with QTc prolongation.Material and Methods: This retrospective study included 96 young adults aged 18–30 years who underwent simultaneous ABPM and Holter electrocardiography (48 overweight: BMI 25.0–29.9 kg/m²; 48 obese: BMI 30.0–39.9 kg/m²). Heart rate variability (HRV) and metabolic indices including HOMA-IR and MetS-IR were evaluated. Regression and ROC analyses were performed to determine factors associated with QTc prolongation (≥450 ms).Results: QTc was longer in obese individuals (429.43±25.27 vs. 405.38±23.44 ms; p<0.001); Tpe and Tpe/QTc did not differ. LF/HF was higher (1.94 vs. 1.59; p<0.001), RMSSD was lower (45.41±10.24 vs. 54.94±9.89 ms; p<0.001), and nocturnal diastolic BP dipping was more impaired (12.07%±9.42 vs. 16.69%±6.85; p=0.009). The factors independently associated with QTc were BMI (β=0.33; p<0.001), CRP (β=0.28; p=0.001), diastolic BP dipping (β=−0.27; p=0.002), and HbA1c (β=0.17; p=0.049); these factors together accounted for 41.3% of the model variance (R²=0.413). HOMA-IR ≥3.36 (AUC=0.722; p=0.002) and a non-dipper diastolic pattern (AUC=0.701; p=0.004) were the strongest discriminators for QTc prolongation.Conclusion: In young obese adults, repolarization prolongation, autonomic dysfunction, and impaired nocturnal BP patterns are observed. The independent association of BMI, CRP, diastolic dipping, and HbA1c with QTc supports the potential clinical importance of QTc, HRV, and ambulatory BP assessment in young obese individuals.

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