Anthropometric And Functional Predictors of Cardiovascular Stress – A Cross-Sectional Study to Assess Their Association Across Normotensives, Pre-Hypertensives and Hypertensives in South India.

Abstract

Background:

Hypertension, one of the most prevalent non-communicable diseases globally, contributes substantially to cardiovascular morbidity and mortality. Overweight and obesity amplify cardiovascular risk through activation of sympathetic and renin-angiotensin pathways, creating a metabolic environment that accelerates vascular and myocardial damage. The Rate Pressure Product (RPP)—a product of heart rate and systolic blood pressure—serves as a non-invasive index of myocardial oxygen consumption and overall cardiac workload. Meanwhile, the Pulse Respiration Quotient (PRQ), representing the ratio of pulse rate to respiratory rate, reflects cardiorespiratory coupling and autonomic balance. Exploring the interrelationship between anthropometric indices and these physiological parameters may provide valuable insight into cardiovascular stress across varying blood pressure categories.

Methods:

A cross-sectional observational study was conducted among 140 participants aged 30 years and above who were either newly diagnosed with hypertension or known hypertensives on treatment. A structured questionnaire was administered to document the demographic details, lifestyle factors and other clinical background. Anthropometric measurements were performed using WHO guidelines. Resting heart rate and blood pressure were recorded in accordance with the international standards. Participants were categorised as normotensives, pre-hypertensives and hypertensives according to JNC 8 guidelines. Group comparisons were made using the independent t-test and one-way ANOVA for continuous variables, while the Chi-square or Fisher’s exact test was used for categorical data. Pearson’s correlation coefficient was applied to examine relationships between anthropometric indices and physiological parameters. A p-value of <0.05 was considered statistically significant.

Results:

Among 130 participants, 12 were normotensive, 69 prehypertensive, and 63 hypertensives. Mean RPP rose progressively across BP groups (8453 ± 1514 vs 9951 ± 1292 vs 11773 ± 1736; p < 0.001), while PRQ remained similar (4.27–4.48; p = 0.41). In regression analysis adjusting for age, sex, and BMI, hypertensive status was independently associated with higher RPP (β = 10 891; 95% CI 2445 – 19 337; p = 0.012). BMI showed a positive but nonsignificant trend with RPP (β = 186; p = 0.13). No significant predictors of PRQ were found.

Conclusion:

RPP, but not PRQ, demonstrates potential as a sensitive hemodynamic marker for cardiovascular risk stratification in hypertensive populations, exhibiting significant discriminatory capacity across blood pressure categories.