Abstract
Adverse cardiovascular outcomes are linked to higher burden of obesity and hypertension. We conducted a secondary analysis of data for 5135 participants aged ≥ 16 years from our community-based hypertension prevalence study to determine the prevalence of obesity and association between multiple anthropometric indices and blood pressure (BP). The indices were waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), a body shape index(ABSI), abdominal volume index (AVI), body adiposity index (BAI), body roundness index (BRI), visceral adiposity index (VAI) and conicity index (CI). We performed statistical analyses to determine the association, predictive ability, cutoff values and independent determinants of hypertension. Crude prevalence of obesity was 136 per 1000 (95% confidence interval 126–146). BMI had the strongest correlation with systolic and diastolic BP (rs = 0.260 and 0.264, respectively). Indices of central adiposity (AVI, WC, WHtR, BRI) were the strongest predictors of hypertension (≥ 140/90 mmHg), and their cut-off values were generally higher in females than males. WHR, age, BMI and CI were independent determinants of hypertension ≥ 140 mmHg (p < 0.05). We conclude that, based on this novel study, measures of central adiposity are the strongest predictors and independent determinants of hypertension in our population, and cut-off values vary from previously recommended standards.
Highlights
Abbreviations a body shape index (ABSI) A body shape index area under curves (AUC) Area under curve abdominal volume index (AVI) Abdominal volume index body adiposity index (BAI) Body adiposity index body mass index (BMI) Body mass index body roundness index (BRI) Body roundness index conicity index (CI) Conicity index HC Hip circumference HREC Health Research Ethics Committee LUTH Lagos University Teaching Hospital non-communicable diseases (NCDs) Non communicable diseases receiver operating characteristic (ROC) Receiver operating characteristic curve SD Standard deviation
Of the 5578 participants recruited in the study, anthropometric data were available for 5135 (92.1% of study participants) and these were included in the secondary analysis
The indices reflective of central adiposity (AVI, waist circumference (WC), waist to height ratio (WHtR) and BRI) were the strongest predictors of systolic and diastolic blood pressure using the ROC analysis. This is important because our findings suggest that measures of central obesity more precisely predict the presence of hypertension compared to BMI
Summary
Abbreviations ABSI A body shape index AUC Area under curve AVI Abdominal volume index BAI Body adiposity index BMI Body mass index BRI Body roundness index CI Conicity index HC Hip circumference HREC Health Research Ethics Committee LUTH Lagos University Teaching Hospital NCDs Non communicable diseases ROC Receiver operating characteristic curve SD Standard deviation. The inter-regional variation in age-standardized prevalence and death rates reinforces the importance of country-specific data to enhance achievement of the translational outlook of the GBD i.e. drive health policy to mitigate the burden. Hypertension and obesity are two of the strongest modifiable risk factors for cardiovascular diseases and other non-communicable diseases including type 2 diabetes mellitus. Population-based interrogation of the relationship between obesity and hypertension is important as such data reinforce existing theories. It contributes to understanding the burden and interactions between potentially modifiable primordial factors amenable to public health interventions and can clarify the strength of the associations considering the regional variations and potential genetic, ethnic and geographic contributions
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