Effect of Body Mass Index on the Relationship between Blood Pressure Levels and Neurological Symptoms among Hypertensive Patients

Objective: Objective of this study was to find out the effect of BMI on relationship between blood pressure and neurological symptoms in hypertensive patients. Method: A cross-sectional study, conducted from Jan to July 2019, at OPD of Medicine, tertiary care hospital in Karachi. Total 234 subjects with age 18 years or above, with self-defined history of hypertension and antihypertensive medication were included while those with history of confirmed diabetes, CVD, neurological disorders, metabolic diseases, and severe obesity were excluded. A questionnaire was utilized to collect baseline data and symptoms associated with hypertension and neurological problems. Blood pressure and BMI were measured by standard methods defined by W.H.O. SPSS version 20.0 was used for data analysis and results were expressed as frequency and percentage. Correlation analysis was used to determine the strength of the association between BMI and BP. P-value <0.05 was taken as statistically significant. Results: The age of 138 (59.0%) patients was <50 years and 96 (41.0%) was >50 years, 123 (52.6%) were males while 111 (47.4%) were females; 12 (5.1%) were underweight, 73 (31.2%) were normal weight, 101 (43.2%) were overweight and 48 (20.5%) were obese; 75 (32.1%) had normal/high normal systolic blood pressure, 128 (54.7%) had grade 1 systolic hypertension while 31 (13.2%) had grade 2/grade 3 systolic hypertension; 120 (51.3%) had normal/high normal diastolic blood pressure, 101 (43.2%) had grade 1 diastolic hypertension while 13 (5.6%) had grade 2/grade 3 diastolic hypertension. Furthermore, 180 (76.9%) had headache, 140 (59.8%) had vertigo, 129 (55.1%) had vision problems, 75 (32.1%) had sleep apnea, 167 (71.4%) had fatigue while 149 (63.7%) of them were suffering from confusion. Underweight/normal weight patients showed that both vertigo (p=0.014) and fatigue (p=0.041) were significantly associated with grade 1 systolic hypertension; while none of the neurological symptom was significantly associated with diastolic blood pressure. Overweight/obese patients showed that both sleep apnea (p<0.001) and confusion (p=0.028) were significantly associated with grade 1 systolic hypertension. While vision problems (p=0.030) and sleep apnea (p=0.038) were significantly associated grade 1 diastolic hypertension. Conclusion: Patients with low BMI showed significant association of neurological symptoms with only Grade 1 systolic blood pressure. While patients with High BMI showed significant association of neurological symptoms with both Systolic and diastolic Grade-1 hypertension.