Weight Stigma in Women Who Are Obese: Assessing How an Acute Exposure to Stigma Negatively Impacts Cardiovascular Health

Not Applicable

Completed

• Conditions: Obesity; Stigma, Social; Blood Pressure; Cardiovascular Disease Risk Factor
• Interventions: Behavioral: Stigma Video Exposure; Behavioral: Neutral video exposure

• Registration Number: NCT04161638
• Lead Sponsor: University of Connecticut

Brief Summary

The current study examined the influence of an acute weight stigma exposure on cardiovascular reactivity among women with obesity and high blood pressure and women with obesity and normal blood pressure.

Detailed Description

The current study examined the influence of two video exposures, one containing scenes of weight stigma (STIGMA) and the other non-stigmatizing neutral (NEUTRAL) scenes, on cardiovascular reactivity as assessed by resting BP and ambulatory blood pressure (ABP) and heart rate (HR), among women with obesity and high BP (HBP) or normal BP (NBP). The investigators hypothesized that as a result of STIGMA compared to NEUTRAL, cardiovascular reactivity would be significantly greater immediately upon watching the video and persist outside of the laboratory over ambulatory conditions in women with obesity and HBP compared to women with obesity and NBP.

Study Timeline

• Study Start: 2016-11-22
• Primary Completion: 2019-01-11
• Study Completion: 2019-01-11
• Study First Submitted: 2019-11-06
• Study First Submitted QC: 2019-11-12
• Study First Posted: 2019-11-13
• Status Verified: 2022-05
• Last Update Submitted: 2022-05-18
• Last Update Posted: 2022-05-25

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 49

Inclusion Criteria

• Premenopausal
• BMI > 30 kg/m2
• No other known chronic cardiovascular or metabolic diseases besides hypertension

Exclusion Criteria

• Pregnant or planned on becoming pregnant
• Took medications that may have affected the primary outcome of BP (e.g., stimulants for attention deficit hyperactivity disorder or steroids for asthma)
• Currently using tobacco products
• Diagnosed with an eating disorder

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Normal Blood Pressure	Neutral video exposure	Participants were placed in the normal BP (NBP) group if they met all of the following criteria: 1) 19-hour average SBP/DBP \< 130/80 mmHg, 2) daytime (awake) average SBP/DBP \< 135/85 mmHg, and 3) night-time (asleep) average SBP/DBP \<120/70 mmHg.
Normal Blood Pressure	Stigma Video Exposure	Participants were placed in the normal BP (NBP) group if they met all of the following criteria: 1) 19-hour average SBP/DBP \< 130/80 mmHg, 2) daytime (awake) average SBP/DBP \< 135/85 mmHg, and 3) night-time (asleep) average SBP/DBP \<120/70 mmHg.
High Blood Pressure	Neutral video exposure	Ambulatory BP measurement was used to confirm the laboratory BP group classification according to the European Society of Hypertension. Participants were placed in the high blood pressure (HBP) group if they met any of the following criteria: 1) 19-hour average systolic BP/diastolic BP (SBP/DBP) \> 130/80 mmHg, 2) daytime (awake) average SBP/DBP \> 135/85 mmHg, or 3) nighttime (sleep) average SBP/DBP \> 120/70 mmHg.
High Blood Pressure	Stigma Video Exposure	Ambulatory BP measurement was used to confirm the laboratory BP group classification according to the European Society of Hypertension. Participants were placed in the high blood pressure (HBP) group if they met any of the following criteria: 1) 19-hour average systolic BP/diastolic BP (SBP/DBP) \> 130/80 mmHg, 2) daytime (awake) average SBP/DBP \> 135/85 mmHg, or 3) nighttime (sleep) average SBP/DBP \> 120/70 mmHg.

Primary Outcome Measures

Name	Time	Method
Ambulatory systolic BP (SABP) reactivity	19 hours (10 hours awake, 9 hours sleep)	Ambulatory SABP reactivity was calculated as the change in hourly SABP values (mmHg) over the awake (10 hours), sleep (9 hours), and 19 hours minus average baseline SABP following STIGMA and NEUTRAL.

Secondary Outcome Measures

Name	Time	Method
Laboratory systolic blood pressure (SBP) reactivity	20 minutes (2 minute intervals) before the exposure video; 10 minutes during the exposure video (2 min intervals); and 20 minutes following the exposure video (2 min. intervals).	Laboratory SBP reactivity was calculated as the change in SBP in millimeters of mercury (mmHg) during the stigma video exposure (STIGMA) and the neutral video exposure (NEUTRAL) and 20-minute post-STIGMA and NEUTRAL minus baseline SBP.
Laboratory diastolic blood pressure (DBP) reactivity	20 minutes (2 minute intervals) before the exposure video; 10 minutes during the exposure video (2 min intervals); and 20 minutes following the exposure video (2 min. intervals).	Laboratory DBP reactivity was calculated as the change in DBP in millimeters of mercury (mmHg) during the stigma video exposure (STIGMA) and the neutral video exposure (NEUTRAL) and 20-minute post-STIGMA and NEUTRAL minus baseline DBP.
Ambulatory rate pressure product (RPP) reactivity	19 hours (10 hours awake, 9 hours sleep)	Ambulatory RPP reactivity in mmHg\*bpm was calculated as ambulatory SBP cardiovascular reactivity (mmHg) multiplied by ambulatory HR reactivity (bpm) (i.e., SBP x HR).
Laboratory heart rate (HR) reactivity	20 minutes (2 minute intervals) before the exposure video; 10 minutes during the exposure video (2 min intervals); and 20 minutes following the exposure video (2 min. intervals).	Laboratory HR reactivity was calculated as the change in HR in beats per minute (bpm) during the stigma video exposure (STIGMA) and the neutral video exposure (NEUTRAL) and 20-minute post-STIGMA and NEUTRAL minus baseline BP.
Laboratory rate pressure product (RPP) reactivity	20 minutes (2 minute intervals) before the exposure video; 10 minutes during the exposure video (2 min intervals); and 20 minutes following the exposure video (2 min. intervals).	Laboratory RPP reactivity in mmHg\*bpm was calculated as laboratory SBP cardiovascular reactivity (mmHg) multiplied by laboratory HR reactivity (bpm) (i.e., SBP x HR).
Ambulatory diastolic BP (DABP) reactivity	19 hours (10 hours awake, 9 hours sleep)	Ambulatory DABP reactivity was calculated as the change in hourly DABP values (mmHg) over the awake (10 hours), sleep (9 hours), and 19 hours minus average baseline DABP following STIGMA and NEUTRAL.
Ambulatory heart rate (HR) reactivity	19 hours (10 hours awake, 9 hours sleep)	Ambulatory heart rate (HR) reactivity was calculated as the change in hourly HR values (bpm) over the awake (10 hours), sleep (9 hours), and 19 hours minus average baseline HR following STIGMA and NEUTRAL.