Epicardial Fat Thickness and Nighttime Systolic Blood Pressure Variability in Healthy Young Adults

Abstract

We recognise epicardial fat thickness (EFT) as a biomarker for cardiometabolic risk and blood pressure variability (BPV) as an independent risk factor for cardiovascular morbidity. While studies link them in hypertensive patients, data for healthy young adults are lacking. This study examines the relationship between EFT-BPV in healthy young adults. Demonstrating this relationship in healthy young adults may be important for the early identification of individuals at higher cardiovascular risk and could inform strategies to reduce future cardiovascular events. This study included 172 apparently healthy young adults (18–41 years old) presenting with atypical chest pain but without known chronic disease or abnormal cardiac findings. EFT was measured via transthoracic echocardiography, and a 24-hour Ambulatory blood pressure monitoring (ABPM) was used to assess BPV. Laboratory tests, body mass index (BMI), and fatty liver index (FLI) were evaluated. Correlations and regression analyses were used to explore associations; significance was set at p < 0.05. Power analysis confirmed an adequate sample size (N = 170, f²=0.15, α = 0.05, power = 0.80). EFT was significantly correlated with 24-hour systolic BPV (r = 0.171, p = 0.028), 24-hour diastolic BPV (r = 0.173, p = 0.025), nighttime systolic BPV (r = 0.193, p = 0.012), and nighttime diastolic BPV (r = 0.183, p = 0.018). In multivariable regression analysis, EFT, smoking, and platelet/basophil ratio were independently associated with nighttime systolic BPV (R² = 0.110, p = 0.002). These findings demonstrate an association between EFT and BPV in apparently healthy young adults, with the strongest association observed for nighttime systolic BPV. Longitudinal studies are needed to clarify directionality and causality. Proposed Mechanisms Underlying the Association Between Epicardial Fat Thickness and Nighttime Systolic Blood Pressure Variability. Based on literature, a schematic illustrating proposed mechanisms that may underlie the association between EFT and nighttime systolic BPV in healthy young adults. EFT may be associated with increased BPV through inflammatory pathways and sympathetic overactivity. Abbreviations: EFT epicardial fat thickness, BPV blood pressure variability Proposed Mechanisms Underlying the Association Between Epicardial Fat Thickness and Nighttime Systolic Blood Pressure Variability. Based on literature, a schematic illustrating proposed mechanisms that may underlie the association between EFT and nighttime systolic BPV in healthy young adults. EFT may be associated with increased BPV through inflammatory pathways and sympathetic overactivity. Abbreviations: EFT epicardial fat thickness, BPV blood pressure variability