Key result
Novel anthropometric indices predict hypertension but fail to outperform traditional indicators like BMI and WC.
Why the study?
It was unknown whether novel indexes (CMI, VAI, DAI, and BAI) are superior to conventional indicators (WC, BMI, WHtR) for predicting future hypertension risk.
Do novel anthropometric indexes (CMI, VAI, DAI, BAI) better predict future hypertension risk compared to conventional indicators (WC, BMI, WHtR) in patients from the MONICA protocol?
Do novel anthropometric indexes (CMI, VAI, DAI, BAI) better predict future hypertension risk compared to conventional indicators (WC, BMI, WHtR) in patients from the MONICA protocol?
Novel anthropometric indexes are independent predictors of hypertension but have inferior predictive discriminatory power compared to traditional indicators like waist circumference and BMI.
Traditional anthropometrics should guide hypertension risk assessment now; reinforces consensus on WC/BMI while leaving open incremental value of novel indexes.
UNLABELLED: Background The objective of this study was to ascertain whether cardiometabolic index(CMI), visceral adiposity index (VAI), dysfunctional adiposity index (DAI), and body adiposity index (BAI) are superior predictors of future hypertension risk when compared with conventional indicators such as waist circumference(WC), body mass index (BMI) and waist-to-height ratio(WHtR). MATERIAL AND METHODS: This is a post hoc analysis of the MONICA protocol. We selected 597 patients based on inclusions criteria. Data collection began in 1992, and follow-up was conducted on the same group of participants in 2007. The study collected anthropometric indexes and biochemical data. RESULTS: After adjusting for confounding factors using multivariate Cox regression analysis, the following results were observed: CMI [HR: 1.754 (1.240-2.480); P = 0.001], VAI [HR: 1.533 (1.074-2.187); P = 0.018], DAI [HR: 1.382 (0.982-1.945); P = 0.064], BAI [HR: 2.791 (1.790-4.352); P < 0.001], WC [HR: 2.234 (1.510-3.307); P < 0.001], WHtR [HR: 2.303 (1.589-3.339); P < 0.001], and BMI [HR: 2.488 (1.778-3.561); P < 0.001] were all significantly associated with the incidence of hypertension. ROC curve analysis showed that the area under the curve (AUC) for WC product was the highest (0.649, 95% CI: 0.605-0.693), followed by BMI (0.648, 95% CI: 0.603-0.692), WHtR (0.646, 95% CI: 0.601-0.690), and then by CMI (0.603, 95% CI: 0.557-0.649). CONCLUSIONS: Although the CMI, VAI, DAI and BAI can all be utilised as independent predictors of hypertension, the predictive discriminatory power of these novel indicators for hypertension remains inferior to that of traditional indicators such as WC, BMI and WHtR.
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Pan et al. (2026) studied this question. While CMI, VAI, DAI, and BAI are independent predictors of hypertension, traditional indicators like WC and BMI possess superior predictive power.
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