Obesity May Exacerbate Long QT Syndrome, A Disorder of
the Heart's Electrical System, in African American Females
New Orleans, LA -- Sedentary lifestyle habits, poor dietary
habits, and childhood obesity are becoming epidemic in America. These
behaviors are more prevalent in children than ever before. Low levels of
physical activity and poor dietary habits are causes of childhood obesity, a
condition associated with risk factors for adult chronic diseases.
Background
Previous studies reveal that African American girls are more likely to be
overweight than Caucasian girls. The trend continues into their adulthood,
as 30 percent of younger (18-30 years) and 77 percent of older (45-65 years)
black women are obese compared to 14 percent and 46 percent respectively,
for their white counterparts. Overall, black women are 60 percent more
likely to become obese than are white women. Women in minority groups are
less physically active than the general American population, and the overall
health status of people of color, including African American women, is lower
than that of the general America population.
Obesity can lead to cardiovascular problems. Another disorder of the
heart is Long QT Syndrome (LQTS), an inherited or acquired condition of the
heart’s electrical system. People with LQTS are at risk for syncope (loss of
consciousness) and sudden death, often at a young age. Although it is known
that African Americans have a higher incidence of obesity compared to
Caucasians, race-specific information is not available for the prevalence of
LQTS. Furthermore, while it is well known that chronic physical activity
reduces the incidence of obesity, little is known about the effects of
chronic physical activity on QT (time from electrocardiogram Q wave to the
end of the T wave corresponding to electrical systole, or contraction and
relaxation of the ventricles) duration.
A new research study, “QTc is Related to Obesity and Physical Activity
Level for African American Females,” has been conducted by C. Jayne Brahler,
Ph.D., Janine T. Baer. Ph.D., R.D. and Patricia A. Dolan, RD., from the
University of Dayton, Dayton, Ohio; and reported by Dr. Brahler and Akbar
Shah MD, from Cardiology South, Inc., Kettering, Ohio, and Emily C. Johnson,
Ph.D., of the Department of Exercise Science, Washington State University,
Pullman, WA. The investigators will present their findings in detail during
the American Physiological Society (APS) annual meeting, which is being held
as part of the Experimental Biology (EB ’02) meeting. More than 12,000
scientific investigators are attending the conference, which begins April
20-24, 2002 at the Ernest N. Morial Convention Center, New Orleans, LA.
Methodology
The subjects were 44 low-income African American women (ages 21-53 years)
and 66 biological daughters (ages 5-17 years). Eligibility criteria included
pre-menopausal, not on estrogen therapy, not pregnant, and apparently
healthy and medically stable, with no known acute heart disease
complications, endocrine problems, complications from diabetes mellitus,
HIV/AIDS, or other major diseases as determined by completing a health
history questionnaire.
Subjects were 12-14 hours fasted upon arrival. Trained faculty and
university student technicians measured body weight, height, and waist and
hip (at the greatest girth of the gluteus) circumferences. BMI was
calculated as weight in kilograms divided by height in meters squared. Waist
to hip ratio (WHR) was calculated as waist circumference (cm) divided by hip
circumference (cm). QT interval was measured from the earliest onset of the
QRS complex to the end of the T wave in lead II. Measurements from five
consecutive beats were averaged. Blood pressure was measured twice; blood
was drawn (10 ml) and sent to a local laboratory for analyses.
An interviewer administered a questionnaire to determine estimated
physical activity levels for adults and adolescents, respectively. These
questionnaires determine the average hours per week over the past year spent
in occupational and leisure physical activity (PA). Each occupational
activity or leisure activity was weighted by an estimate of its relative
intensity or metabolic equivalent (MET).
Subject data were blocked by the body mass index (BMI) for normal weight
(BMI<25), overweight (BMI 25-29.99), and obesity (BMI>30), with children’s
BMI values being adjusted for age and sex. ANOVA tests were run to determine
if significant differences existed in QTc between BMI groups. Physical
activity data were blocked according to subjects who engaged in low (0.0 -
9.9 MET-hr/week), medium (10.0 - 35. 0 MET-hr/week) and high (>35
MET-hr/week) PA and ANOVA analyses completed to determine if PA
significantly affected QTc duration.
Results
Significantly longer QTc and significantly higher systolic and diastolic
blood pressure values and fasting blood glucose levels were found for obese
subjects compared to normal-weight mothers and daughters. QTc was positively
correlated with WHR, and SBP and DBP for mothers, but not daughters.
The average physical activity level for 56 percent of the women and 73
percent of the girls was less than 3.9 MET-hours per week, which is lower
than the Surgeon General’s recommendation of 7.5-15 MET-hours per week.
There was an inverse association between self-reported physical activity
and QTc for mothers and daughters, which reached statistical significance
for the obese daughters.
Conclusion
These results indicate a positive association between obesity and long
QTc and an inverse association between self reported PA and QTc duration.
Consequently, otherwise healthy individuals with obesity are at an increased
risk for acquiring LQTS and the associated malignant ventricular
arrhythmias. LQTS can be identified via a resting electrocardiograph (ECG)
tracing, yet it is not common practice to screen otherwise healthy obese
individuals for these conditions.
Chronic aerobic exercise training may protect against LQTS, but, to our
knowledge, no one has quantified the exercise intensity, duration or length
of training period required to favorably affect the LQTS. Combined with
other risk factor information, determining the effect of a controlled
exercise intervention on LQTS may have positive implications for informing
healthy lifestyle habits, especially for a population at risk for developing
obesity and engaging in low levels of PA, such as African American women and
their daughters.
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The American Physiological Society (APS) is one of the
world’s most prestigious organizations for physiological scientists. These
researchers specialize in understanding the processes and functions
underlying human health and disease. Founded in 1887 the Bethesda, MD-based
Society has more than 10,000 members and publishes 3,800 articles in its 14
peer-reviewed journals each year.
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Editor’s Note: For further information or to schedule an interview, please contact Donna Krupa at 703.967.2751 (cell),
703.527.7357 (office) or at
djkrupa1@aol.com.