Abstract

BackgroundTo date, the best adiposity index that predicts or associates strongly with hypertension remains controversial. Therefore, we aimed to compare the performance of different adiposity indices [BMI (body mass index), WC (waist circumference), WHtR (waist-to-height ratio), ABSI (a body shape index), VAI (visceral adipose index), BFP (body fat percentage)] as associates and potential predictors of risk of hypertension among Chinese population.MethodsA cross-sectional survey was conducted in Jiangxi province, China from 2013 to 2014. A total of 14,573 participants were included in the study. The physical measurements included body height, weight, WC, BFP and VAI. Multivariate logistic regression analysis was performed to assess the associations between different adiposity indices and the prevalence of hypertension. Receiver operating characteristic (ROC) analysis was also performed.ResultsAll adiposity indices were independently and positively associated with the prevalence of hypertension in a dose response fashion. The area under the curves (AUCs) for WHtR, BFP and VAI were significantly larger than those for other adiposity indices in both males and females (all P < 0.01). For males, no statistically significant difference was found in AUCs among WHtR and BFP (0.653 vs. 0.647, P = 0.4774). The AUC of WHtR was significantly higher than VAI (0.653 vs. 0.636, P < 0.01). For females, the AUCs demonstrated that WHtR was significantly more powerful than BFP and VAI (both P < 0.05) for predicting hypertension [WHtR, 0.689 (0.677–0.702); BFP, 0.677 (0.664–0.690); VAI, 0.668 (0.655–0.680)]. Whereas no significant differences were found in AUCs for hypertension among BFP and VAI in both sexes (all P > 0.1). The AUCs for hypertension associated with each adiposity index declined with age in both males and females. For subjects aged < 65 years, WHtR still had the largest AUC. However, for participants aged ≥65 years, BMI had the largest AUC.ConclusionThe findings indicated that WHtR was the best for predicting hypertension, followed by BFP and VAI, especially in younger population.

Highlights

  • To date, the best adiposity index that predicts or associates strongly with hypertension remains controversial

  • No statistically significant difference was found in Area under the curve (AUC) among waist-to-height ratio (WHtR) and body fat percentage (BFP) (0.653 vs. 0.647, P = 0.4774)

  • The AUCs demonstrated that WHtR was significantly more powerful than BFP and visceral adipose index (VAI) for predicting hypertension [WHtR, 0.689 (0.677–0.702); BFP, 0.677 (0.664–0.690); VAI, 0.668 (0.655–0.680)]

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Summary

Introduction

The best adiposity index that predicts or associates strongly with hypertension remains controversial. We aimed to compare the performance of different adiposity indices [BMI (body mass index), WC (waist circumference), WHtR (waist-to-height ratio), ABSI (a body shape index), VAI (visceral adipose index), BFP (body fat percentage)] as associates and potential predictors of risk of hypertension among Chinese population. Hypertension is increasingly regarded as a widespread global disease and the leading modifiable risk factor for cardiovascular disease [1, 2]. The results from China Hypertension Survey during 2012–2015 showed that the prevalence of hypertension among the Chinese adult population was 23.2% [3]. Previous studies have reported that the modifiable risk factors for hypertension include salt intake, obesity, abdominal obesity, smoking, drinking and sleep duration [4,5,6]

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