Anthropometric predictors of hypertension among Moroccan adults: a cross-sectional study

Background Hypertension remains a major public health challenge worldwide, particularly in low- and middle-income countries. Obesity-related anthropometric indicators are widely used to assess cardiovascular risk; however, evidence regarding the most reliable predictors of hypertension remains inconsistent across populations. Therefore, this study aimed to determine the prevalence of overweight and obesity based on general and central adiposity indicators, assess the association between multiple anthropometric measures and hypertension, and identify the most reliable predictor of hypertension among Moroccan adults. Methods 400 Moroccan adults were involved in this cross-sectional study. Sociodemographic, lifestyle, clinical, and anthropometric data were collected. Hypertension was defined according to international guidelines. Receiver operating characteristic (ROC) curve analysis was used to assess discriminatory performance, with optimal cut-off values determined using the Youden index. Multivariable logistic regression models were applied to identify independent associations. Results Hypertension was present in 75.0% of participants. The prevalence of overweight and obesity was 58.3 and 8.8%, respectively, indicating that 67.1% of the study population had excess body weight. Waist-to-height ratio (WHtR) showed the strongest independent association with hypertension (ORa = 6.79, 95% CI: 3.57–12.90, p < 0.001). In ROC analysis, WHtR demonstrated the highest discriminatory performance (AUC = 0.793, 95% CI: 0.744–0.842), outperforming waist-to-hip ratio (AUC = 0.657,95% CI: 0.596–0.718), body fat percentage (AUC = 0.603, 95% CI: 0.538–0.668), visceral fat level (AUC = 0.584, 95% CI: 0.525–0.642), and body mass index (AUC = 0.568, 95% CI: 0.503–0.633). The optimal WHtR cut-off value of 0.505 yielded a sensitivity of 79.7% and specificity of 63.0%. Conclusion Waist-to-height ratio, appears to be the most reliable anthropometric predictors of hypertension among Moroccan adults. Given its simplicity and low cost, WHtR may represent a practical tool for community-based screening and early identification of individuals at increased risk of hypertension in Morocco.