The close association of excess adiposity and elevated blood pressure is well documented. The role of obesity as a contributing factor for resistant hypertension, cardiovascular disease, and cerebrovascular disease is recognized. Given that exercise training could be used to treat both obesity and elevated blood pressure when patients are admitted for trauma care, identifying obesity-associated systolic hypertension may help with long-term control of the root causes for these illnesses.

PURPOSE: To examine the relationship between body composition, blood pressure, and other measures collected on patient admittance.

METHODS: Data were collected from 2,306 consecutive patients admitted to a Level 1 trauma center between July, 2012 and June 2015. Patients with head trauma or traumatic brain injury were not analyzed. Patients were considered obese if their BMI was ≥ 30. Multiple linear regression was used to examine the effect of obesity on blood pressure. Other significant variables were examined from the database that contributed to the prediction model.

RESULTS: Significant predictors of systolic hypertension included blood lactate, age, obesity, pulse pressure, pH, %O2 saturation and hemoglobin levels (R=0.464; p<0.001). Holding all other variables constant, obesity was associated with a 9.7 mmHg increase in systolic blood pressure (p=0.009). A mild (3 mmHg) increase in diastolic blood pressure was noted, but was not found to be statistically significant (p=0.172).

CONCLUSIONS: The demonstrated relationship between obesity and systolic blood pressure illustrates the need for integrated blood pressure and obesity treatment with exercise training. Therapeutic exercise focused on weight loss goals will likely ameliorate elevated systolic blood pressure. Weight management discussions are challenging, and often avoided by health professionals, but these data show that concomitant antihypertensive medication with therapeutic exercise training may be warranted for prevention of subsequent cardiovascular and cerebrovascular diseases.