Comparison of BMI and Waist Circumference with the Risk of Uncontrolled Hypertension Among Adult Population in Bogor, Indonesia (Longitudinal Data Analysis Using Generalized Estimating Equations)

Uncontrolled hypertension increases the risk of cardiovascular morbidity and mortality. Longitudinal studies comparing the effect of BMI and waist circumference with the prevalence of uncontrolled hypertension is limited. This study aims to compare the effects of obesity using BMI and waist circumference criteria with uncontrolled hypertension. Longitudinal data from the Indonesia-Cohort Bogor Study in 2011 -2018 was used. The population was adult aged 25 -65 years who became subjects of the Indonesia-Cohort Bogor Study in 2011 and 2012. The sample was subjects with hypertension at the beginning of the study and have completed 6 years of follow-up period. The total of 481 subjects or 2,866 personyears were analysed using the Generalized Estimating Equations (GEE). The results showed that in the 6-years of follow-up period in all groups of subjects, the risk of uncontrolled hypertension was 1.621 times (95% CI: 1.160 -2.267) and 1.987 times (95% CI: 1.450 -2.722) in subjects who experienced overweight and obesity compared to subjects with normal BMI; and 1.437 times (95% CI: 1.136 -1,819) in subjects who experienced central obesity compared to subjects with normal waist circumference, adjusted by age, smoking behavior, natrium intake and year of follow-up. Based on the results of the analysis by gender, the risk of uncontrolled hypertension was higher in male group who experienced overweight, obese, or central obesity compared with female group. Obesity using BMI calculation was stronger predictor than central obesity using waist circumference for the risk of uncontrolled hypertension. The results of this study are expected to be used for improving intervention and controlling hypertension programs in Indonesia.