Metabolic and Lifestyle Factors in Arterial Hypertension: Insights From a Hospitalized Population

Introduction Recent European Society of Cardiology guidelines prioritize the importance of an integrated approach to the management of arterial hypertension (AH), emphasizing lifestyle changes [1]. Excess visceral fat is strongly associated with hypertension and metabolic dysregulation, contributing to increased blood pressure through inflammatory and hormonal pathways [2]. Elevated blood pressure can contribute to nocturia by increasing nighttime urination. Since nocturnal blood pressure fluctuations often go undetected, nocturia may serve as an important indicator of these changes [3]. Aim The study aims to look at the relationship between AH and potential metabolic and lifestyle risk factors, as well as the occurrence of nocturia in hospitalized patients. Methods This study involved 121 patients (65 women, 56 men) hospitalised for cardiovascular and neurological diseases between 2023 and 2025. Their mean age was 65 ± 13 years. Patients were stratified according to AH status: 88 with AH and 33 without AH. Data on lifestyle, habits and medical conditions were collected in a specially designed questionnaire and body composition was assessed with a TANITA BC-545N segmental body composition analyzer. Statistical analyses were performed using IBM SPSS 26.0. The groups were compared using the Mann-Whitney U test, with medians and interquartile range (IQR). The Chi-square (χ²) test was used to assess associations between categorical variables. Statistical significance level was set at p < 0.05. Results Elevated visceral fat levels were observed in patients with AH compared to patients who did not have AH (69.3% vs. 39.4%, respectively; p=0.03). A BMI ≥ 30 kg/m² was more frequently observed in patients with AH compared to those without AH (40.9% vs. 21.2%, respectively; p = 0.045). BMI was significantly higher in patients with AH (median = 29.0, IQR = 8.1) compared to those without AH (median = 27.3, IQR = 5.6), as indicated by a MannWhitney U test (p = 0.026). A significant association was found between physical activity levels and AH status (χ²(2) = 6.42, p = 0.04). Patients without AH were more likely to have high physical activity (60.6% vs. 35.2%), whereas low physical activity was more common among AH patients (17.0% vs. 12.1%). A significant association was found between AH and nocturia (χ²(1) = 6.72, p = 0.01), nocturia was more frequent in AH patients than in those without AH (80.7% vs. 57.6%). Conclusions The results of this study revealed an association between AH and certain lifestyle and metabolic factors. Considering that all patients were hospitalized for various diseases, the possibility that hypertension and increased BMI are common risk factors for hospitalization cannot be ruled out. Furthermore, in men, benign prostatic hyperplasia may have influenced the nocturia results, so this aspect should be considered as one of the limitations of the study.