The association between body mass index and hypertension is different between East and Southeast Asians - PubMed (original) (raw)
The association between body mass index and hypertension is different between East and Southeast Asians
Tuan T Nguyen et al. Am J Clin Nutr. 2009 Jun.
Abstract
Background: Few studies have allowed direct comparison of the association between body mass index (BMI; in kg/m2) and hypertension in different Asian ethnicities.
Objective: We compared the association of BMI with hypertension in Chinese, Indonesian, and Vietnamese adults and determined BMI cutoffs that best predicted hypertension in these populations.
Design: We included 7562 Chinese, 18,502 Indonesian, and 77,758 Vietnamese participants aged 18-65 y. Blood pressure, weight, and height were measured by trained health workers. To define an optimal BMI cutoff, we computed and searched for the shortest distance on receiver operating characteristic curves.
Results: Despite a low mean BMI, the prevalences of hypertension in Chinese, Indonesian, and Vietnamese men were 22.9%, 24.8%, and 14.4%, respectively, and in women were 16.6%, 26.9%, and 11.7%, respectively. At all BMI levels, the sex-specific prevalence of hypertension was higher in Indonesian adults than in Chinese and Vietnamese adults (P < 0.05 at almost all BMI levels). The overall and stratified analyses suggested optimal BMI cutoffs of 23-24, 21-22.5, and 20.5-21 for Chinese, Indonesian, and Vietnamese adults, respectively. The cutoffs were approximately 0.5-1.0 units higher in women than in men and in the older (41-65 y) than in the younger (18-40 y) participants.
Conclusions: The study showed an ethnic difference in the BMI-hypertension association and in optimal BMI cutoffs between Chinese, Indonesian, and Vietnamese adults. Country-specific or even country-, sex-, and age-specific BMI cutoffs might be needed to identify persons at high risk of cardiovascular diseases.
Figures
FIGURE 1
Distribution of BMI (in kg/m2) in women (A) and men (B). The samples included men from China (n = 3913), Indonesia (n = 8888), and Vietnam (n = 39,711) and women from China (n = 3649), Indonesia (n = 9614), and Vietnam (n = 38,047). The participants were 18- to 65-y-old men and women (nonpregnant or nonlactating) for whom measurements of weight, height, and blood pressure were complete and plausible (eg, BMI: 15–35; weight: 30–150 kg; height: 130–190 cm; and difference between systolic and diastolic blood pressures: ≥10 mm Hg). Data were weighted to represent ≈50%, 83%, and 100% of the Chinese, Indonesian, and Vietnamese populations, respectively.
FIGURE 2
Prevalence of hypertension by BMI level in Chinese, Indonesian, and Vietnamese adults: crude prevalence in women (A), crude prevalence in men (B), at age of 40 y in women (C), and at age of 40 y in men (D). The samples included men from China (n = 3913), Indonesia (n = 8888), and Vietnam (n = 39,711) and women from China (n = 3649), Indonesia (n = 9614), and Vietnam (n = 38,047). The participants were 18- to 65-y-old men and women (nonpregnant or nonlactating) for whom measurements of weight, height, and blood pressure were complete and plausible (eg, BMI: 15–35; weight: 30–150 kg; height: 130–190 cm; and difference between systolic and diastolic blood pressures: ≥10 mm Hg). Data were weighted to represent ≈50%, 83%, and 100% of the Chinese, Indonesian, and Vietnamese populations, respectively. The 95% CIs for the prevalence estimates are presented in Supplemental Table 1 under “Supplemental data” in the online issue. *Significantly different from the Chinese, P < 0.05 (chi-square test). ‡Significantly different from the Vietnamese, P < 0.05 (chi-square test). P for trend < 0.001 for all.
FIGURE 3
Prevalence ratios of hypertension by BMI level in Chinese, Indonesian, and Vietnamese: crude value in women (A), crude value in men (B), age-adjusted in women (C), and age-adjusted in men (D). The samples included men from China (n = 3913), Indonesia (n = 8888), and Vietnam (n = 39,711) and women from China (n = 3649), Indonesia (n = 9614), and Vietnam (n = 38,047). The participants were 18- to 65-y-old men and women (nonpregnant or nonlactating) for whom measurements of weight, height, and blood pressure were complete and plausible (eg, BMI: 15–35; weight: 30–150 kg; height: 130–190 cm; and difference between systolic and diastolic blood pressures: ≥10 mm Hg). Data were weighted to represent ≈50%, 83%, and 100% of the Chinese, Indonesian, and Vietnamese populations, respectively. The 95% CIs for the prevalence estimates are presented in Supplemental Table 2 under “Supplemental data” in the online issue. *Significantly different from the Chinese, P < 0.05 (2-sided independent t test). ‡Significantly different from the Vietnamese, P < 0.05 (2-sided independent t test). P for trend < 0.001 for all.
FIGURE 4
Receiver operating characteristic (ROC) curves for the prediction of hypertension by BMI in Chinese, Indonesian, and Vietnamese adults: in both sexes (A), in women (B), and in men (C). The samples included men from China (n = 3913), Indonesia (n = 8888), and Vietnam (n = 39,711) and women from China (n = 3649), Indonesia (n = 9614), and Vietnam (n = 38,047). The participants were 18- to 65-y-old men and women (nonpregnant or nonlactating) for whom measurements of weight, height, and blood pressure were complete and plausible (eg, BMI: 15–35; weight: 30–150 kg; height: 130–190 cm; and difference between systolic and diastolic blood pressures: ≥10 mm Hg). The 95% CIs of the area under the ROC curve are presented in Supplemental Table 3 under “Supplemental data” in the online issue.
References
- WHO Expert Consultation Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157–63 - PubMed
- Deurenberg P, Deurenberg-Yap M, Guricci S. Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes Rev 2002;3:141–6 - PubMed
- Wang J, Thornton JC, Russell M, Burastero S, Heymsfield S, Pierson RN., Jr Asians have lower body mass index (BMI) but higher percent body fat than do whites: comparisons of anthropometric measurements. Am J Clin Nutr 1994;60:23–8 - PubMed
- Macaulay V, Hill C, Achilli A, et al. Single, rapid coastal settlement of Asia revealed by analysis of complete mitochondrial genomes. Science 2005;308:1034–6 - PubMed
- Bei-Fan Z. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults: study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Asia Pac J Clin Nutr 2002;11(Suppl 8)S685–93 - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical