Internal and Emergency Medicine

, Volume 13, Issue 4, pp 509–516 | Cite as

Visceral adiposity index (VAI), a powerful predictor of incident hypertension in prehypertensives

  • Zhipeng Zhang
  • Di Shi
  • Qiang Zhang
  • Si Wang
  • Kai Liu
  • Qingtao Meng
  • Xiaoping Chen


Prehypertension (defined by The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, JNC-7) is relevant to a higher cardiovascular risk than normotensives. Early intervention in this particular population is essential to avoid progression into hypertension (HTN). This study is to explore whether visceral adiposity index (VAI) can strongly predict the incidence of HTN in community-based prehypertensives. A prospective observational cohort study was conducted from September 2011 to June 2012 in urban communities of Chengdu, Sichuan Province, China. 780 subjects (male 320, female 460) were evaluated on anthropometrical indices, blood pressure, blood samples, brachial-ankle pulse wave velocity, of whom 360 prehypertensives (male 160, female 200) were recruited for a 5-year follow-up. Overall, 97 subjects (male 37, female 60) developed HTN. The risk for developing HTN in the future increases with increasing VAI levels. The OR of the upper quartile is 3.719 (95% CI 1.481–9.338, P = 0.005) after adjusting for confounders. The ROC results reveal that VAI is not considered superior to other indices on account of the significant overlapping confidence intervals. The area under the curves (AUC) of Model 5 (combination of VAI and WC) is significantly higher than BMI, WC and WHR (P < 0.05). The AUC of Model 4 (combination of VAI and BMI) is found to be significantly higher than BMI and WHR (P < 0.05), and is also higher than WC in all subject groups and in the male subgroup, but not in the female subgroup. VAI at baseline is an independent risk factor and early predictor of incident HTN in prehypertensives. The predictive value is not stronger than other traditional obesity indices (BMI, WC and WHR); however, it is superior to the latter by combining VAI and WC. Namely, VAI may help identify individuals at high risk of evolving into HTN in this particular population.


Visceral adiposity index Prehypertension BaPWV 





visceral adiposity index


waist circumference


body mass index




high density lipoprotein-cholesterol


brachial-ankle pulse wave velocity


ankle-brachial index


fating blood glucose


total cholesterol


low density lipoprotein-cholesterol


receiver operating characteristic


waist-to-hip ratio



The authors thank Dr. Chen, who has been a source of encouragement.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All patients participated in the study have read and signed the informed consent.


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Copyright information

© SIMI 2018

Authors and Affiliations

  • Zhipeng Zhang
    • 1
  • Di Shi
    • 1
  • Qiang Zhang
    • 1
  • Si Wang
    • 1
  • Kai Liu
    • 1
  • Qingtao Meng
    • 1
  • Xiaoping Chen
    • 1
  1. 1.Department of Cardiology, West China HospitalSichuan UniversityChengduChina

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