Abstract 13300: The Risk of Incident Hypertension According to the Metabolic Health and Obesity: Definition of Metabolic Health Does Not Matter

Abstract

Background: Obesity is considered to be an important risk factor for hypertension. The metabolically healthy obese (MHO) phenotype refers to obese individuals with a favorable metabolic profile. Its prognostic value remains controversial and may partly depend on differences in defining methods. We examined the risk of MHO phenotype with incident hypertension in a Korean population using four representative criteria to define metabolic health status. Design and methods: The study population comprised of 31,033 Koreans without hypertension. Participants were stratified by body mass index (BMI) (cut-off value, 25.0 kg/m2) and metabolic health state, according to four defining methods; Adult Treatment Panel (ATP)-III criteria, Wildman criteria, Karelis criteria, and Homeostasis Model Assessment (HOMA) criteria. Results: Over the median follow-up period of 35.0 months (range, 4.5-81.4 months), 4,589 of the 31,033 individuals (14.8%) developed incident hypertension. Compared with the metabolically healthy nonobese (MHNO) group, the MHO group showed increased risk of incident hypertension with a multivariate-adjusted hazard ratio (HR) of 1.42 (95% confidence interval [CI], 1.30-1.54), 1.43 (95% CI 1.31-1.57), 1.41 (95% CI 1.27-1.56), and 1.33 (95% CI 1.23-1.45), when defined by ATP-III criteria, Wildman criteria, Karelis criteria, and HOMA criteria, respectively. Metabolically unhealthy obese (MUO) individuals were at the highest risk of incident hypertension. Conclusions: MHO subjects showed a substantially higher risk of incident hypertension regardless of the definition for metabolic health. Thus, it is important to consider both metabolic health and obesity when evaluating risk of hypertension.