THE INFLUENCE OF BODY MASS INDEX ON CARDIORENOMETABOLIC PARAMETERS ACROSS BLOOD PRESSURE CATEGORIES

Objective: Excess body weight influences metabolic, cardiovascular (CV), and renal function, with varying effects depending on blood pressure (BP) status. This study examines the impact of body mass index (BMI) on cardiorenometabolic parameters and CV risk across normotensive (NT), prehypertensive (PHT), and hypertensive (HT) individuals.Design and method: A cross-sectional study of 326 participants categorized into NT (n=103), PHT (n=143), and HT (n=80). BMI was classified as less than 24.9 kg/m2(normal weight) and more than 25.0 kg/m2(overweight/obese). Metabolic (HOMA-IR, insulin, lipids), inflammatory (CRP, fibrinogen), and renal (eGFR, GFR, ACR) parameters were analyzed. CV risk was assessed using standard risk scores. Results: BMI influences cardiorenometabolic markers across all BP categories, with progressive deterioration from NT to HT. In NT: Overweight/obese individuals had higher insulin (p=0.001), HOMA-IR (p<0.001), CRP (p=0.008), and uric acid (p=0.002), suggesting early metabolic alterations. Renal changes included higher eGFR (p<0.001) but lower GFR (p<0.001), while ACR remained unchanged. In PHT: Metabolic disturbances intensified, with higher HOMA-IR (p=0.02), triglycerides (p=0.03), and CRP (p=0.006). Renal function followed a pattern of higher eGFR (p<0.001) and lower GFR (p=0.01), indicative of early hyperfiltration. In HT: The highest burden was observed, with worse insulin resistance (p<0.001), inflammation (CRP p<0.001), and CV risk (48.1%). Renal function showed persistent hyperfiltration (eGFR p=0.01), significantly lower GFR (p<0.001), and elevated ACR, suggesting renal impairment. Multivariate analysis identified hypertension (OR=55.9), smoking (OR=131.9), and total cholesterol (OR=12.2) as key CV risk predictors, while HDL (OR=0.002) was protective. Conclusions: BMI exerts a progressive impact on cardiorenometabolic parameters across BP categories. Even in NT, excess weight is associated with early metabolic and renal changes, which worsen in PHT and further deteriorate in HT. These findings emphasize the need for early weight management to prevent CV and renal complications.