Body composition, leg length and blood pressure in a rural Italian population: A test of the capacity-load model

•We tested contributions of growth and body composition to blood pressure variability.•Metabolic load (fat and lean masses) was associated with higher blood pressure.•Metabolic capacity (longer leg length) was associated with lower blood pressure.•The two sexes showed some differences in these associations.

Background and aimsWhereas adult weight or body mass index (BMI) are directly associated with blood pressure (BP), birth weight is inversely associated with BP. The scenario for height is more complex, as both tall and short stature have been associated with higher BP. We used a theoretical model treating sitting height (SH) and tissue masses (fat mass, lean mass) as components of metabolic load, and leg length (LL) as a marker of homeostatic metabolic capacity. We predicted that decreased capacity and increased load would be independently associated with increased BP..Methods and resultsAnthropometry, body composition (bio-electrical impedance analysis) and BP were measured in 601 adults (228 male) aged 20–91 years from three hill villages in southern Italy. Multiple regression analysis was used to investigate associations of body composition and anthropometry with BP. Adjusting for age, systolic BP (SBP) was associated with lean mass in males, and with adiposity in females, whereas diastolic BP (DBP) was associated with fat mass in both sexes. Associations of LL and SH with BP were in opposite directions. LL was inversely associated with SBP and DBP in males, with a similar trend evident in females. SH was directly associated with SBP and DBP in females, and with DBP in males.ConclusionsConsistent with our theoretical model, metabolic load is associated with increased BP, though differently between the sexes, whereas metabolic capacity is independently associated with lower BP. Our findings suggest that early growth improves hemodynamic tolerance of high metabolic load in adulthood..