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High Blood Pressure & Cardiovascular Prevention

, Volume 22, Issue 3, pp 265–273 | Cite as

Associations Between Hypertension and Body Mass Index and Waist Circumference in U.S. Adults: A Comparative Analysis by Gender

  • Ranjana Roka
  • Akihiko MichimiEmail author
  • Gretchen Macy
Original Article

Abstract

Introduction

The body mass index (BMI) and waist circumference (WC) are a risk of hypertension, but their potentially multiplicative effect on hypertension is underexplored.

Aim

To examine modifying effects of BMI and WC on hypertension using a nationally representative U.S. adult sample stratified by gender.

Methods

Data were derived from the 2009–2010 NHANES. Overweight and obesity were based on BMI of 25.0–29.9 and ≥30 kg/m2, respectively. High-risk WC was based on ≥102.0 and ≥88.0 cm for males and females, respectively. Hypertension was determined by systolic/diastolic blood pressure of ≥140/≥90 mmHg, or taking prescribed medications. Logistic regression was used to examine the association between hypertension and BMI and WC by gender. Interaction terms were added to examine if BMI modified the effect of WC on hypertension.

Results

Both BMI and WC were significant predictors of hypertension in overall population. Gender-specific models indicated that BMI played an important role in hypertension risk among males, but WC in females. The interaction effects were present among males implying that the association of WC with hypertension was stronger if subjects were overweight or obese. This effect, however, was not present in females.

Conclusion

BMI and WC may influence hypertension differently among males and females.

Keywords

Hypertension Body mass index Waist circumference Obesity Gender 

Notes

Conflict of interest

The authors declare no conflict of interest.

References

  1. 1.
    CDC. Vital signs: prevalence, treatment, and control of hypertension-United States, 1999–2002 and 2005–2008. Morb Mortal Wkly Rep. 2011;60(4):103–8.Google Scholar
  2. 2.
    Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden VB, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2013;127:e9–245.CrossRefGoogle Scholar
  3. 3.
    Vasan RS, Beiser A, Seshadri S, Larson MG, Kannel WB, D’Agostino RB, et al. Residual lifetime risk for developing hypertension in middle-aged women and men: the Framingham Heart Study. JAMA. 2002;287(8):1003–10.CrossRefPubMedGoogle Scholar
  4. 4.
    Wang TJ, Vasan RS. Contemporary reviews in cardiovascular medicine: epidemiology of uncontrolled hypertension in the United States. Circulation. 2005;112:1651–62.CrossRefPubMedGoogle Scholar
  5. 5.
    Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Montani JP, Antic V, Yang Z, Dulloo A. Pathways from obesity to hypertension: from the perspective of a vicious triangle. Int J Obes Relat Metab Disord. 2002;26(Suppl 2):S28–38.CrossRefPubMedGoogle Scholar
  7. 7.
    Narkiewicz K. Obesity and hypertension—the issue is more complex than we thought. Nephrol Dial Transplant. 2006;21:264–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G. Mechanisms of obesity-induced hypertension. Hypertens Res. 2010;33:386–93.CrossRefPubMedGoogle Scholar
  9. 9.
    Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206–52.CrossRefPubMedGoogle Scholar
  10. 10.
    Nyamdorj R, Qiao Q, Soderberg S, Pitkaniemi J, Zimmet P, Shaw J, et al. Comparison of body mass index with waist circumference, waist-to-hip ratio, and waist-to-stature ratio as a predictor of hypertension incidence in Mauritius. J Hypertens. 2008;26(5):866–70.CrossRefPubMedGoogle Scholar
  11. 11.
    Ho SY, Lam TH, Janus ED, Hong Kong Cardiovascular Risk Factor Prevalence Study Steering Committee. Waist to stature ratio is more strongly associated with cardiovascular risk factors than other simple anthropometric indices. Ann Epidemiol. 2003;13(10):683–91.CrossRefPubMedGoogle Scholar
  12. 12.
    Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004;79(3):379–84.PubMedGoogle Scholar
  13. 13.
    Deng WW, Wang J, Liu MM, Wang D, Zhao Y, Liu YQ, et al. Body mass index compared with abdominal obesity indicators in relation to prehypertension and hypertension in adults: the CHPSNE study. Am J Hypertens. 2013;26(1):58–67.CrossRefPubMedGoogle Scholar
  14. 14.
    Sakurai M, Miura K, Takamura T, Ota T, Ishizaki M, Morikawa Y, et al. Gender differences in the association between anthropometric indices of obesity and blood pressure in Japanese. Hypertens Res. 2006;29:75–80.CrossRefPubMedGoogle Scholar
  15. 15.
    Luo W, Guo Z, Hao C, Yao X, Zhou Z, Wu M, et al. Interaction of current alcohol consumption and abdominal obesity on hypertension risk. Physiol Behav. 2012. doi: 10.1016/j.physbeh.2012.10.004.
  16. 16.
    Niskanen L, Laaksonen DE, Nyyssonen K, Punnonen K, Valkonen V-P, Fuentes R, et al. Inflammation, abdominal obesity, and smoking as predictors of hypertension. Hypertension. 2004;44:859–65.CrossRefPubMedGoogle Scholar
  17. 17.
    Pitsavos C, Chrysohoou C, Panagiltakos DB, Lentzas Y, Stefanadis C. Abdominal obesity and inflammation predicts hypertension among prehypertensive men and women: the ATTICA Study. Heart Vessels. 2008;23(2):96–103.CrossRefPubMedGoogle Scholar
  18. 18.
    Buemann B, Tremblay A. Effects of exercise training on abdominal obesity and related metabolic complications. Sports Med. 1996;21(3):191–212.CrossRefPubMedGoogle Scholar
  19. 19.
    Ostchega Y, Hughes JP, Terry A, Fakhouri TH, Miller I. Abdominal obesity, body mass index, and hypertension in US adults: NHANES 2007–2010. Am J Hypertens. 2013;25(12):1271–8.Google Scholar
  20. 20.
    Gallant MP, Dorn GP. Gender and race differences in the predictors of daily health practices among older adults. Health Educ Res. 2001;16(1):21–31.CrossRefPubMedGoogle Scholar
  21. 21.
    Steptoe A, McMunn A. Health behaviour patterns in relation to hypertension: the English Longitudinal Study of Ageing. J Hypertens. 2009;27(2):224–30.CrossRefPubMedGoogle Scholar
  22. 22.
    Hays NP, Bathalon GP, McCrory MA, Roubenoff R, Lipman R, Roberts SB. Eating behavior correlates of adult weight gain and obesity in healthy women aged 55–65 y. Am J Clin Nutr. 2002;75(3):476–83.PubMedGoogle Scholar
  23. 23.
    Flom PL, Strauss SM. Some graphical methods for interpreting interactions in logistic and OLS regression. Mult Linear Regres Viewp. 2003;29(1):1–7.Google Scholar
  24. 24.
    Bennett JA. Mediator and moderator variables in nursing research: conceptual and statistical differences. Res Nurs Health. 2000;23:415–20.CrossRefPubMedGoogle Scholar
  25. 25.
    Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173–82.CrossRefPubMedGoogle Scholar
  26. 26.
    Han TS, Williams K, Sattar N, Hunt KJ, Lean ME, Haffner SM. Analysis of obesity and hyperinsulinemia in the development of metabolic syndrome: San Antonio Heart Study. Obes Res. 2002;10(9):923–31.CrossRefPubMedGoogle Scholar
  27. 27.
    Ghosh JR, Bandyopadhyay AR. Comparative evaluation of obesity measures: relationship with blood pressures and hypertension. Singap Med J. 2007;48(3):232–5.Google Scholar
  28. 28.
    Hirani V, Zaninotto P, Primalesta P. Generalized and abdominal obesity and risk of diabetes, hypertension and hypertension-diabetes co-morbidity in England. Public Health Nutr. 2007;11(5):521–7.PubMedGoogle Scholar
  29. 29.
    Yalcin BM, Sahin EM, Yalcin E. Which anthropometric measurements is most closely related to elevated blood pressure? Fam Pract. 2005;22(5):541–7.CrossRefPubMedGoogle Scholar
  30. 30.
    Decoda Study Group, Nyamdorj R, Qiao Q, Lam TH, Tuomilehto J, Ho SY, et al. BMI compared with central obesity indicators in relation to diabetes and hypertension in Asians. Obesity. 2008;16(7):1622–35.CrossRefGoogle Scholar
  31. 31.
    Benetou V, Bamia C, Trichopoulos D, Mountokalakis T, Psaltopoulou T, Trichopoulou A. The association of body mass index and waist circumference with blood pressure depends on age and gender: a study of 10,928 non-smoking adults in the Greek EPIC cohort. Eur J Epidemiol. 2004;19(8):803–9.CrossRefPubMedGoogle Scholar
  32. 32.
    Howel D. Waist circumference and abdominal obesity among older adults: patterns, prevalence and trends. PLoS One. 2012;7(10):e48528.PubMedCentralCrossRefPubMedGoogle Scholar
  33. 33.
    Zhu S, Heshka S, Wang Z, Shen W, Allison DB, Ross R, et al. Combination of BMI and waist circumference for identifying cardiovascular risk factors in whites. Obes Res. 2004;12(4):633–45.CrossRefPubMedGoogle Scholar
  34. 34.
    Blaak E. Gender differences in fat metabolism. Curr Opin Clin Nutr Metab Care. 2001;4:499–502.CrossRefPubMedGoogle Scholar
  35. 35.
    Chei C-L, Iso H, Yamagishi K, Tanigawa T, Cui R, Imano H, et al. Body fat distribution and the risk of hypertension and diabetes among Japanese men and women. Hypertens Res. 2008;31(5):851–7.CrossRefPubMedGoogle Scholar
  36. 36.
    Maas AHEM, Franke HR. Women’s health in menopause with a focus on hypertension. Neth Heart J. 2009;17(2):68–72.PubMedCentralCrossRefPubMedGoogle Scholar
  37. 37.
    Williams PT. A cohort study of incident hypertension in relation to changes in vigorous physical activity in men and women. J Hypertens. 2008;26(6):1085–93.PubMedCentralCrossRefPubMedGoogle Scholar
  38. 38.
    Denton M, Walters V. Gender differences in structural and behavioral determinants of health: an analysis of the social production of health. Soc Sci Med. 1999;48(9):1221–35.CrossRefPubMedGoogle Scholar
  39. 39.
    Williams PT. A cohort study of incident hypertension in relation to changes in vigorous physical activity in men and women. J Hypertens. 2008;26(6):1086–93.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Public HealthCollege of Health and Human Services, Western Kentucky UniversityBowling GreenUSA

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