1. ¹Department of Community Health, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
2. ²Department of Public Health, Faculty of Medicine, Gadjah Mada University, Jogjakarta, Indonesia
3. ³Faculty of Public Health, Hanoi Medical University, Hanoi, Vietnam
4. ⁴Umeå International School of Public Health, Epidemiology and Public Health Sciences, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
5. ⁵Evidence for Information and Policy (EIP), World Health Organization, Geneva

Correspondence: Dr F Tesfaye, Department of Community Health, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia. E-mail: ttfikru@yahoo.com

Received 30 May 2006; Revised 1 September 2006; Accepted 1 September 2006; Published online 26 October 2006.

Abstract

Despite a growing burden of obesity and hypertension in developing countries, there is limited information on the contribution of body mass index (BMI) to blood pressure (BP) in these populations. This study examines the association between BMI and BP in three populations across Africa and Asia. Data on BMI, BP and other background characteristics of study participants were generated using the World Health Organization STEPwise approach to surveillance (STEPS), at three demographic surveillance sites in Ethiopia, Vietnam and Indonesia. BMI and BP increased along the socioeconomic gradient across the three countries. Mean (s.d.) BMI in men varied between 19.41 (2.28) in Ethiopia to 21.17 (2.86) in Indonesia. A high prevalence of overweight/obesity was noted among Indonesian women (25%) and men (10%), whereas low BMI was widely prevalent in Ethiopia and Vietnam, ranging from 33 to 43%. Mean (s.d.) systolic BP (SBP) among men varied between 117.15 (15.35) in Ethiopia to 127.33 (17.80) in Indonesia. The prevalence of hypertension was highest among women (25%) and men (24%) in Indonesia. Mean BP levels increased with increasing BMI. The risk of hypertension was higher among population groups with overweight and obesity (BMI25 kg/m²); odds ratio (95% confidence interval); 2.47 (1.42, 4.29) in Ethiopia, 2.67 (1.75, 4.08) in Vietnam and 7.64 (3.88, 15.0) in Indonesia. BMI was significantly and positively correlated with both SBP and DBP in all the three populations, correlation coefficient (r) ranging between 0.23 and 0.27, P<0.01. High BP exists in a background of undernutrition in populations at early stages of the epidemiologic transition.