Background:
Although several studies have reported associations of general and regional adiposity with hypertension risk, limited data are available in multi-ethnic cohorts.
Methods:
Cross-sectional associations of body mass index (BMI), waist circumference (WC), and peripheral circumference measures (neck [NC], arm [AC], hips [HC], and thigh [TC]) with hypertension risk was examined in a cohort of 504 multi-ethnic men and women (mean age, 46 years; 76% women; 23% Caucasian, 31% African-American, and 46% Hispanic). Patients were recruited from a community free clinic (Forsyth County, NC) to participate in the Take Off the Pressure Study (TOPS) during April to September, 2011. Associations of adiposity measures with hypertension risk by ethnicity were assessed using logistic regression after adjusting for age and sex.
Results:
Overall, 49% of participants (51%, 76%, and 29% of Caucasians, African-Americans, and Hispanics, respectively) had hypertension (BP >140/90 or previous diagnosis). Positive associations with hypertension risk were observed for BMI, WC, AC, HC and NC among Caucasians, and for WC among Hispanics (
Table
). In other words, Caucasians with higher BMI, and larger waist, arm, hip, and neck circumferences, and Hispanics with a larger waist circumference, were more likely to have hypertension. Notably, each 1-inch increase in arm and neck circumference was associated with 30% and 56% higher risks of hypertension, respectively among whites. However, no significant associations between any adiposity measure and hypertension risk were observed among African-Americans.
Conclusion:
Hypertension was highly prevalent in this cohort, particularly among African-Americans. However, adiposity markers used to assess hypertension risk in Caucasians may not apply to individuals of other ethnicities.
Table.
Age- and sex-adjusted odds ratios (95% CI) for hypertension by adiposity indicator/ethnicity
Caucasian (n = 117)
African-American (n = 156)
Hispanic (n = 231)
BMI (per kg/m
2
)
1.09 (1.03-1.15)
1.03 (0.99-1.08)
1.03 (0.97-1.08)
Waist circ (per in)
1.11 (1.04-1.18)
1.05 (0.99-1.11)
1.06 (1.00-1.11)
Arm circ (per in)
1.30 (1.05-1.62)
1.11 (0.94-1.31)
1.11 (0.93-1.33)
Thigh circ (per in)
1.06 (0.93-1.20)
1.09 (0.97-1.21)
0.98 (0.87-1.10)
Hip circ (per in)
1.09 (1.02-1.17)
1.04 (0.99-1.10)
1.03 (0.97-1.10)
Neck circ (per in)
1.56 (1.19-2.03)
1.15 (0.90-1.47)
1.14 (0.91-1.44)