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Comparison of body mass index, waist circumference, conicity index, and waist-to-height ratio for predicting incidence of hypertension: the rural Chinese cohort study

Abstract

This study compared the ability of body mass index (BMI), waist circumference (WC), conicity index, and waist-to-height ratio (WHtR) to predict incident hypertension and to identify the cutoffs of obesity indices for predicting hypertension in rural Chinese adults. This prospective cohort study recruited 9905 participants aged 18–70 years during a median follow-up of 6 years in rural China. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to assess the association, predictive ability, and optimal cutoffs (in terms of hypertension risk factors) of the four obesity indices: BMI, WC, conicity index, and WHtR. The 6-year cumulative incidence of hypertension was 19.89% for men and 18.68% for women, with a significant upward trend of increased incident hypertension with increasing BMI, WC, conicity index, and WHtR (P for trend < 0.001) for both men and women. BMI and WHtR had the largest area under the ROC curve for identifying hypertension for both genders. The optimal cutoff values for BMI, WC, conicity index, and WHtR for predicting hypertension were 22.65 kg/m2, 82.70 cm, 1.20, and 0.49, respectively, for men, and 23.80 kg/m2, 82.17 cm, 1.20, and 0.52, respectively, for women. BMI, WC, conicity index, and WHtR cutoffs may offer a simple and effective way to screen hypertension in rural Chinese adults. BMI and WHtR were superior to WC and conicity index for predicting incident hypertension for both genders.

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Acknowledgements

We thank the dedicated participants and all research staff of the study.

Funding

This study was supported by the National Natural Science Foundation of China (grant numbers 81373074, 81402752, and 81673260); the Natural Science Foundation of Guangdong Province (grant number 2017A03013452); the Medical Research Foundation of Guangdong Province (grant number A2017181); and the Science and Technology Development Foundation of Shenzhen (grant numbers JCYJ20140418091413562, JCYJ 2016030715570, JCYJ 20170302143855721, and JCYJ20170412110537191).

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Correspondence to Dongsheng Hu.

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The authors declare that they have no conflict of interest.

Electronic supplementary material

41371_2018_33_MOESM1_ESM.doc

Supplementary material 1. Follow-up characteristics of rural Chinese adults by blood pressure status at follow-up overall and by normotension and hypertension

41371_2018_33_MOESM2_ESM.doc

Supplementary material 2. Receiver operating characteristic (ROC) curves for obesity indices in terms of incident hypertension overall and by gender

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Chen, X., Liu, Y., Sun, X. et al. Comparison of body mass index, waist circumference, conicity index, and waist-to-height ratio for predicting incidence of hypertension: the rural Chinese cohort study. J Hum Hypertens 32, 228–235 (2018). https://doi.org/10.1038/s41371-018-0033-6

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