Abstract
To investigate which of four anthropometric variables of obesity has the strongest association with blood pressure (BP), and to investigate whether there are gender differences in these relationships in Asian adults, we evaluated the associations of four anthropometric variables, body mass index (BMI), waist circumference, waist-to-hip ratio and waist-to-height ratio, with BP and the prevalence of hypertension in a cross-sectional study. A total of 4,557 employees of a metal-products factory in Toyama, Japan (2,935 men and 1,622 women, aged 35 to 59 years) were included in the study. Waist circumference in men and BMI in women had the strongest associations with BP. As for the age-adjusted rate ratio (RR) of the prevalence of hypertension for one standard deviation increase in each anthropometric variable, RR was the highest for waist circumference in men (RR, 1.44; 95% confidence interval [CI], 1.31–1.58), and for BMI in women (RR, 1.61; 95% CI, 1.38–1.88). The associations of waist circumference in men and BMI in women remained significant after adjustment for each of the other variables. The associations of waist-to-height ratio with BP and the prevalence of hypertension were a little weaker than those of waist circumference for both men and women. In conclusion, among four anthropometric variables of obesity—i.e., BMI, waist circumference, waist-to-hip ratio, and waist-to-height ratio—waist circumference had the strongest association with BP and the prevalence of hypertension in men and BMI had the strongest association with BP and hypertension in women. Waist circumference in men and BMI in women should be given more importance in the screening of and guidelines on hypertension in Asians.
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Kannel WB, Brand N, Skinner JJ Jr, Dawber TR, McNamara PM : The relation of adiposity to blood pressure and development of hypertension: the Framingham study. Ann Intern Med 1967; 67: 48–59.
Stamler J : Epidemiologic findings on body mass index and blood pressure in adults. Ann Epidemiol 1991; 1: 347–362.
Bell AC, Adair LS, Popkin BM : Ethnic differences in the association between body mass index and hypertension. Am J Epidemiol 2002; 155: 346–353.
Brown CD, Higgins M, Donato KA, et al: Body mass index and prevalence of hypertension and dyslipidemia. Obesity Res 2000; 8; 605–619.
Whelton PK, Appel LJ, Espeland MA, et al, for the TONE Collaborative Research Group: Sodium reduction and weight loss in the treatment of hypertension in older persons. A randomized controlled trial of nonpharmacologic interventions in the elderly. JAMA 1998; 279: 839–846.
Cutler JA : Randomized clinical trials of weight reduction in nonhypertensive persons. Ann Epidemiol 1991; 1: 363–370.
Stevens VJ, Obarzanek E, Cook NR, et al, for the Trials of Hypertension Prevention Research Group: Long-term weight loss and changes in blood pressure: result of the trials of hypertension prevention, phase II. Ann Intern Med 2001; 134: 1–11.
Davis BR, Blaufox MD, Oberman A, et al: Reduction in long-term antihypertensive medication requirements. Effects of weight reduction by dietary intervention in overweight persons with hypertension. Arch Intern Med 1993; 153: 1773–1782.
Ishizaka N, Ishizaka Y, Toda E, Hashimoto H, Nagai R, Yamakado M : Hypertension is the most common component of metabolic syndrome and the greatest contributor to carotid arteriosclerosis in apparently healthy Japanese individuals. Hypertens Res 2005; 28: 27–34.
National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults : Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 2001; 285: 2486–2497.
Takeuchi H, Saitoh S, Takagi S, et al: Metabolic syndrome and cardiac disease in Japanese men: applicability of the component of metabolic syndrome defined by the National Cholesterol Education Program–Adult Treatment Panel III to Japanese men—the Tanno and Sobetsu Study. Hypertens Res 2005; 23: 203–208.
Nakamura T, Tokunaga K, Shimomura I, et al: Contribution of visceral fat accumulation to the development of coronary artery disease in non-obese men. Atherosclerosis 1994; 107: 239–246.
Sparrow D, Borkan GA, Gerzof SG, Wisniewski C, Silbert CK : Relationship of fat distribution to glucose tolerance. Results of computed tomography in male participants of the Normative Aging Study. Diabetes 1986; 35: 411–415.
Hans TS, van Leer EM, Seidell JC, Lean MEJ : Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ 1995; 311: 1401–1405.
Ross R, Leger L, Morris D, de Guise J, Guardo R : Quantification of adipose tissue by MRI: relationship with anthropometric variables. J Appl Physiol 1992; 72: 787–795.
Dalton M, Cameron AJ, Zimmet PZ, et al, on behalf of the Audsdiab Steering Committee : Waist circumference, waist-hip ratio and body mass index and their correlation with cardiovascular disease risks in Australian adults. J Intern Med 2003; 254: 555–563.
Ho SY, Lam TH, Janus ED : Waist to stature ratio is more strongly associated with cardiovascular risk factors than other simple anthropometric indices. Ann Epidemiol 2003; 13: 683–691.
Zhu SK, Wang ZM, Heshka S, Heo M, Faith MS, Heymsfield SB : Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds. Am J Clin Nutr 2002; 76: 743–749.
Siani A, Cappuccio FP, Barba G, et al: The relationship of waist circumference to blood pressure: the Olivetti Heart study. Am J Hypertens 2002; 15: 780–786.
Foucan L, Hanley J, Deloumeaux J, Suissa S : Body mass index and waist circumference as screening tools for cardiovascular risk factors in Guadeloupean women. J Clin Epidemiol 2002; 55: 990–996.
Kotani K, Tokunaga K, Fujioka S, et al: Sexual dimorphism of age-related changes in whole-body fat distribution in the obese. Int J Obes Relat Metab Disord 1994; 18: 207–212.
Morikawa Y, Nakagawa H, Ishizaki M, et al: Ten-year follow-up study on the relation between the development of non-insulin dependent diabetes mellitus and occupation. Am J Ind Med 1997; 31: 80–84.
Ishizaki M, Yamada Y, Morikawa Y, et al: The relationship between waist-to hip ratio and occupational status and life-style factors among middle-aged male and female Japanese workers. Occup Med 1999; 49: 177–182.
Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y : Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index. Am J Clin Nutr 2000; 72: 694–701.
WHO Expert Consultation : Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004; 363: 157–163.
Hayashi T, Boyko EJ, Leonetti DL, et al: Visceral adiposity and prevalence of hypertension in Japanese Americans. Circulation 2003; 108: 1718–1723.
Hsieh SD, Muto T : The superiority of waist-to-height ratio as an anthropometric index to evaluate clustering of coronary risk factors among non-obese men and women. Prev Med 2005; 40: 216–220.
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Sakurai, M., Miura, K., Takamura, T. et al. Gender Differences in the Association between Anthropometric Indices of Obesity and Blood Pressure in Japanese. Hypertens Res 29, 75–80 (2006). https://doi.org/10.1291/hypres.29.75
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DOI: https://doi.org/10.1291/hypres.29.75
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