Abstract
ObjectiveThis study aimed to quantify the associations of regional fat mass and fat‐free mass with systolic blood pressure.MethodsThis analysis combined individual participant data from two large‐scale imaging studies: UK Biobank and Oxford BioBank. In both studies, participants were interviewed and measured, and they underwent dual‐energy x‐ray absorptiometry imaging. Linear regression was used to relate systolic blood pressure to anthropometric measures of adiposity (BMI, waist circumference, and waist to hip ratio) and dual‐energy x‐ray absorptiometry–derived measures of body composition (visceral android fat, subcutaneous android fat, subcutaneous gynoid fat, and fat‐free mass).ResultsAmong 10,260 participants (mean age 49; 96% white), systolic blood pressure was positively associated with visceral android fat (3.2 mmHg/SD in men; 2.8 mmHg/SD in women) and fat‐free mass (1.92 mmHg/SD in men; 1.64 mmHg/SD in women), but there was no evidence of an association with subcutaneous android or gynoid fat. Associations of systolic blood pressure with BMI were slightly steeper than those with waist circumference or waist to hip ratio; these associations remained unchanged following adjustment for fat‐free mass, but adjustment for visceral android fat eliminated associations with waist circumference and waist to hip ratio and more than halved associations with BMI.ConclusionsThis analysis indicates that visceral fat is the primary etiological component of excess adiposity underlying the development of adiposity‐related hypertension.
Highlights
Adiposity is an established risk factor for vascular disease, and this association is known to be mediated in part by raised blood pressure
In both men and women, systolic blood pressure was positively associated with visceral fat and fat-free mass, but there was no evidence of an association with subcutaneous android fat or gynoid fat
The results indicate that much of the relation between systolic blood pressure and commonly used anthropometric measures of adiposity are explained by their correlation with visceral fat
Summary
Adiposity is an established risk factor for vascular disease, and this association is known to be mediated in part by raised blood pressure. Previous studies of adiposity and blood pressure have mostly used indirect measures of adiposity, such as BMI, waist circumference, or waist to hip ratio. The etiological relevance of general adiposity (as measured by BMI) and central adiposity (as measured by waist circumference or waist to hip ratio) has been inferred from these findings. BMI has been found to be more strongly related to blood pressure than measures of central adiposity [4,5]. In Western populations, BMI that is 1 kg/m2 higher is typically associated with approximately 1-mmHg higher systolic blood pressure [6]. These different measures of adiposity are highly correlated and are associated with differing levels
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