BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital out patients: a cross-sectional study (original) (raw)
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BMJ Open, 2021
Objective: This non-inferiority study aimed to determine the burden of obesity in a hospital outpatient setting of a developing country, using three commonly employed metrics as predictors of hypertension (HTN). Design: A cross-sectional study design was adopted. Setting This study was conducted in Health Promotion and Risk Factor Screening Services of a tertiary hospital for eye and ear, nose, throat in a semiurban area of Nepal. Participants 2256 randomly selected outpatients between 40 and 69 years old. Outcome measures: The three obesity metrics and HTN were analysed for association using correlation, the area under the receiver operating characteristic (ROC) curve and ORs. Results: The prevalence of obesity or overweight by body mass index (BMI) was 58.29%; by waist-to-height ratio (WHtR) was 85.95%, high waist circumference (WC) was observed among 66.76% of participants. Female participants had a greater prevalence of high WC (77.46%) than males (53.73%) (p<0.001). Prevalence of HTN and pre-HTN were 40.67% and 36.77%, respectively. The areas under the ROC curve were significantly higher than 0.5 for BMI (0.593), WHtR (0.602) and WC (0.610). Conclusion: This study showed that WHtR and WC measured were not inferior to BMI as a metric for obesity detection and HTN prediction. Because of its low cost, simplicity of measurement and better ability to predict HTN, it may become a more usable metric in health facilities of low-income and middle-income countries.
Journal of Nepalgunj Medical College, 2018
Aim: Obesity is associated with the metabolic risk factors such as high blood pressure, body fat abnormality, and glucose intolerance which may influence the morbidity and mortality due to cardiovascular diseases. The present study is to determine the correlation of common anthropometric indices of obesity with blood pressure among population in mid-western region of Nepal. The result will provide us insight on relevant anthropometric indices for predicting hypertension based on linear correlation calculated from our data. Methods: We screened 500 healthy subjects to study the correlation between anthropometric indices and blood pressure. Result: Our result showed strong correlation between Sum of Skin fold, waist circumference, and waist hip ratio with blood pressure (systolic blood pressure, diastolic blood pressure and mean arterial blood pressure). However some of the anthropometric indices like hip circumference and body mass index did not have significant correlation with blood pressure. Conclusion: Provided obesity related morbidity and mortality is burgeoning in our society it is imperative to identify right indicators of cardiovascular disease for specific population. Relevant anthropometric indices can serve as excellent indicators if used based of scientific validation.
International Journal of Pharmaceutical Biological Archive, 2012
This study is aim at determining the correlations between the derived and basic anthropometric indices in hypertension among the people at Chitwan District of Nepal. A total 500 subjects above aged 20 were recruited for the study. This study was conducted from 7 th November, 2011 to 15 th November 2011. All historical information was obtained by interview and medical records. Height and weight were measured after the removal of shoes and with the patients wearing light clothing. Similarly, waist circumference was measured using a steel measuring tape, with measurements made halfway between the lower border of the ribs, and the iliac crest in a horizontal plane. Hip circumference was measured around the widest portion of the buttocks, with the tape parallel to the floor. The result showed that the mean value of waist hip ratio (WHR) for male participants fell below the range for the overweight and obese, while the mean value of WHR for female participants fell within the range classified as obese. The mean body mass index (BMI) for all the participants fell within the healthy weight range. Furthermore, there was a significant relationship between the systolic blood pressure as well as the diastolic blood pressure, and the indices of adiposity of all the participants (p=0.0001).In conclusion, WHR is a strong independent indicator of hypertension, particularly in men aged 40-59 years and women aged 40-69 years. However, age disparity in relation to hypertension was not taken into consideration.
Background: Waist circumference (WC) is a useful surrogate marker of abdominal adiposity and a risk factor of cardiovascular disease and hypertension. Asians have higher abdominal fat at a lower level of body mass index (BMI). Previous studies showed that WC was the best measure and correlate of abdominal fat and general adiposity, respectively, among the Bengalee people of Eastern India including the present sample. This study aimed to evaluate the clinical usefulness of waist circumference and its appropriate cut-off in identifying obesity and hypertension. Methods: Adult male slum dwellers aged between 18 and 60 years were included in the study. Height, weight, skinfolds, waist circumference, systolic-(SBP) and diastolic blood pressures (DBP) were measured. Body mass index (BMI) and percent body fat (PBF) were also calculated. Obesity was defined as >25% of body fat. Mean (+ SD) and range statistics were used to describe the variables. WC values were divided into four categories, viz. <72cm, 72-79.9cm, 80-84.9cm and ≥ 85.0cm. ANCOVA was performed to observe the differences in mean SBP and, DBP between the WC categories, with age, smoking and alcohol consumption status as covariates. Pearson correlation and multiple linear regressions were employed to examine the relationship of WC with SBP and DBP. Adjusted odds ratios for hypertension by WC categories were obtained through logistic regression analysis. Receiver operating characteristic (ROC) curve analysis revealed the optimal value of WC to identify obesity. Results and conclusions: PBF increased significantly (F = 208.74, p<0.001) from the lowest WC category (10.6%) to the highest one (26.9%). Mean SBP and DBP also increased significantly from the lowest to the highest WC categories. Waist circumference had significant positive effect on both SBP (T=2.559, p<0.01) and DBP (T=3.256, p<0.05) irrespective of age and PBF. WC value >80.9cm could be accepted as the best cut-off point for WC to identify obesity. Participants with a WC of 80-84.9 cm were around three times more likely to have HT(p<0.005), however the likelihood increased to over 5 for those with a WC of > 85.0 cm when compared to lower WC categories. The odds ratio significantly increased for WCs at or above 80cm. Therefore the measurement of WC could be used to identify general obesity and be used as a screening tool for HT risk factors in Bengalee urban slum dwelling men. The WC cut off to define obesity and identifying hypertension was around 81cm.
Background: Waist circumference (WC) has been previously shown to be the most efficient measure to explain variability in body mass index (BMI) and percentage body fat (PBF) in Bengalee males, including those under study. Aim: The objective was to evaluate the relative usefulness of WC and its single suitable value, if any, to identify both generalized obesity and hypertension in Bengalee men. Subjects and methods: This cross-sectional study included 433 adult (18-60 years) Bengalee Hindu slum dwelling men. Height, weight, waist circumference, systolic (SBP) and diastolic (DBP) blood pressures were measured. BMI was computed as weight (in kg) divided by height (in metres) squared. Hypertension (HT) was defined as SBP $ 140 mmHg and/or DBP $ 90 mmHg. A BMI $ 23 kg/m 2 and $ 25 kg/m 2 were considered overweight and obesity, respectively. Receiver operating characteristic (ROC) curve analyses were employed to determine the best cut-off points to define HT and overweight. Results: Prevalence of HT, overweight and obesity were 17.6% and 20.1% and 8.3%, respectively. Prevalence of central obesity using the cut-offs of 102 cm, 90 cm and 80 cm were 0.46%, 5.08% and 24.7%, respectively. Both in obese and non-obese, WC $ 80 cm was significantly associated with higher SBP and DBP than WC , 80 cm. WC . 79.4 cm and . 80.3 cm were the most appropriate for detecting HT and overweight status. Conclusion: WC value of ,80 cm could efficiently discriminate both obesity and hypertension among the Bengalee Hindu slum dwelling men aged between 18-60 years. Central obesity, determined by WC $ 80 cm, was associated with increased blood pressure and higher risk of HT, independent of age and general obesity.
Clinical Hypertension
Background Although there has been a well-established association between overweight-obesity and hypertension, whether such associations are heterogeneous for South Asian populations, or for different socioeconomic groups is not well-known. We explored the associations of overweight and obesity using South Asian cut-offs with hypertension, and also examined the relationships between body mass index (BMI) and hypertension in various socioeconomic subgroups. Methods We analysed the recent Demographic and Health Survey (DHS) data from Bangladesh, India, and Nepal, with a total of 821,040 men and women. Hypertension was defined by 2017 ACC/AHA cut-offs and by Joint National Committee 7 (JNC7) cut-offs for measured blood pressure and overweight and obesity were defined by measured height and weight. We used multiple logistic regressions to estimate the odds ratios (ORs) with 95% confidence intervals (CIs) of hypertension for overweight and obesity as well as for each 5-unit increase in B...
Introduction: Recent findings show a high incidence of stroke among slum dwellers in Kolkata, India. This cross-sectional study aimed to compare the association of different adiposity indices to blood pressure (BP) and hypertension (HT) among slum-dwelling Bengalee men in Kolkata. Methods: Measurements of height, weight, waist and hip-circumferences, biceps, triceps, subscapular and suprailiac skinfolds, systolic (SBP) and diastolic (DBP) of 470 men aged 18-60 years were taken. Body mass index (BMI), body adiposity index (BAI), percent body fat, waist-height (WHtR) and waist-hip ratios (WHR) were computed. The effect of adiposity values on HT was estimated by logistic regressions, while partial correlations and linear regressions analyses of SBP and DBP with each index were performed. Results: BMI had the strongest correlation with blood pressure. The newly proposed index, BAI, had significant but considerably lower correlations with both BP compared to BMI and central adiposity. Both BMI and WHtR explained DBP with equal efficacy. Abdominal obesity, measured by WC, showed the strongest association with risk of HT, independent of age and BMI. The predictive effect of abdominal adiposity on blood pressure (SBP and DBP) appeared to be modified by age-BMI interaction. Conclusion: BAI showed no advantage over other adiposity measures in the prediction of hypertension among the men in this study. Waist circumference was the best obesity measure to predict hypertension and may be preferred to BMI considering its simplicity of measurement. The simple measure of WC might help in easy screening of hypertension among the poor people in resource constrained settings such as those in urban slums.
Cut-off of body mass index and waist circumference to predict hypertension in Indian adults
World Journal of Clinical Cases, 2014
contributed to conception and design of the study, acquisition of data, or analysis and interpretation of data, drafting the article and final approval of the version to be published; Rao YK, Pandey U and Kaur S helped in conception and design of the study, interpretation of data, revising the article and final approval of the version to be published.
Evaluation of Anthropometric Measurements as Predictor of Hypertension in North Indian Females
2018
DOI: 10.21276/sjams.2017.5.12.43 Abstract: Adiposity has been found to be associated with increased risk of noncommunicable diseases, especially hypertension, cardiovascular diseases, coronary arteriosclerosis, and overall mortality. The aim of this study was to determine correlations among various anthropometric parameters and blood pressure in North Indian females. A total number of 200 females aged between 25-60 years were included in the study. Their weight, height, waist circumference (WC), hip circumference, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Body mass index (BMI), waist hip ratio (WHR) and waist height ratio (WHtR) were calculated subsequently. The relationship between WC, BMI, WHR, WHtR and blood pressure was assessed using Pearson’s correlation coefficient analysis. WC, BMI, WHR and WHtR were independently associated with both systolic and diastolic blood pressure. WHR was found to be more closely associated with systolic (p<0...
Although there has been a well-established association between adiposity and hypertension, whether such associations are heterogeneous for South Asian populations or for different socioeconomic groups is not well-known. We analysed the recent Demographic and Health Survey (DHS) data from Bangladesh, India, and Nepal to estimate the age-specific prevalence of hypertension and the association of body mass index (BMI) with hypertension. We used multiple logistic regressions to estimate the odds ratios (ORs) with 95% confidence intervals (CIs) of hypertension for overweight and obesity as well as for each 5-unit increase in BMI. The overall prevalence for hypertension among participants aged 35-44 years were 17.4%, 20%, and 22.5% for Bangladesh, India, and Nepal, respectively. For all age groups, men were more likely to be hypertensive than women in India and Nepal, but not in Bangladesh. Overweight and obesity were associated with higher odds of hypertension in all countries. For each ...