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Waist circumference, not body mass index, is associated with blood pressure in a sample of young Chinese adults

Journal of Human Hypertension volume 20, pages 904–906 (2006)Cite this article

Cardiovascular disease (CVD) is a global problem, even in developing countries like China. Previous research has shown a link between two risk factors for cardiovascular disease, blood pressure and body mass index (BMI). However, the relevance of using the traditional BMI scale for a Chinese population has been questioned. One of the major independent risk factors for CVD, hypertension with high systolic blood pressure (SBP), is associated with increased risk of CVD in western populations as well as in the Chinese population.1, 2 Obesity, once thought to be problematic only in developed countries is another major risk factor for CVD that has become a global issue, with an estimated 30–40 million people in China who are obese.1 Improvements in the Chinese economy and changes in lifestyle are believed to have contributed to this obesity problem.3

Traditionally, the BMI has been used to estimate body fat, with adult BMI values >25 kg/m2 indicative of being overweight, while individuals with BMI values >30 kg/m2 being defined as obese.4 A large body of research has demonstrated that being overweight or obese (as assessed by the BMI) is associated with elevated blood pressure (BP) levels and increased risk for hypertension.5 For example, in a random stratified cluster sample of 2068 Chinese men and women hypertensive patients of both genders had significantly higher mean BMI than their normotensive counterparts.5 Nevertheless, controversy has arisen with regard to the appropriateness of a universal BMI definition of obesity. Based on the WHO criteria using BMI estimates, <5% of the Chinese population is obese6 and it has been suggested that this is a gross underestimation of the prevalence of obesity and consequently those at risk for CVD.7 Owing to differing body types, it has recently been suggested that the ranges for BMI be lowered for Asian populations, for example, a BMI in the range of 24–27.9 might be defined as overweight and ⩾28 as obese.8 While BMI has proven to be a useful measure of hypertension risk because of its positive correlation with adiposity, it does not provide any information about body fat distribution.9 More recently, other measures such as waist circumference and waist-to-hip-ratio have been found to be more strongly associated with obesity-related health risks.1, 2, 10 Thus, the purpose of the present study is to compare BMI versus waist circumference as predictors of BP levels in a sample of young adult Chinese men and women.

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Acknowledgements

Funding for this study was provided by the University of Calgary.

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Authors and Affiliations

  1. Department of Psychology, University of Calgary, Calgary, Alberta, Canada

    S Yap & T S Campbell

  2. School of Psychology, Beijing Normal University, Beijing, China

    Z Yang & J Wang

  3. Department of Exercise Science, Concordia University, Montreal, Quebec, Canada

    S L Bacon

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  1. S Yap
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  2. Z Yang
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  3. J Wang
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  4. S L Bacon
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  5. T S Campbell
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Correspondence to T S Campbell.

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Yap, S., Yang, Z., Wang, J. et al. Waist circumference, not body mass index, is associated with blood pressure in a sample of young Chinese adults. J Hum Hypertens 20, 904–906 (2006). https://doi.org/10.1038/sj.jhh.1002081

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