Key result
Higher BMI linked to ~41% higher odds of prehypertension, outperforming other adiposity indices.
Why the study?
The association between adiposity indices and prehypertension remained unclear in the Chinese non-hypertensive population.
Which adiposity indices (BMI, WC, WHtR, BRI, ABSI, or CI) are most strongly associated with and best predict prehypertension in non-hypertensive Chinese adults?
Cross-Sectional (n=61,475)
Yes
Which adiposity indices (BMI, WC, WHtR, BRI, ABSI, or CI) are most strongly associated with and best predict prehypertension in non-hypertensive Chinese adults?
Traditional adiposity indices (waist circumference and BMI) are at least as effective as novel body shape indices (BRI, ABSI, CI) for identifying prehypertension in Chinese adults, supporting obesity control for primary prevention of hypertension.
BMI and WC may aid prehypertension identification in Chinese adults; leaves open whether novel indices add value in prospective cohorts.
The association of adiposity indices with prehypertension remains unclear in the Chinese non-hypertensive population. This study aimed to compare the association of adiposity indices, including waist circumference (WC), waist-to-height ratio, body roundness index (BRI), a body shape index (ABSI), and conicity index (CI), and prehypertension in the Chinese population. We recruited 61 475 participants from a population-based screening project in Guangdong province, China. Multiple logistic regression analyses were performed to detect the association between the six adiposity indices and prehypertension. Receiver operator characteristic curve (ROC) analysis was used to evaluate the predictive values of adiposity indices to prehypertension. The individuals were divided into two categories by blood pressure (BP) levels: normotension (<120/80 mmHg) and prehypertension (120-139/80-89 mmHg). A total of 33 233 people had prehypertension, with a prevalence of 54.04% and 42% males. Both logistics regression models presented a positive association between each adiposity index and prehypertension (p < .05), except for ABSI. The body mass index (BMI) was slightly more correlated with prehypertension than any other index. The standardized ORs for the six indices were 1.392, 1.361, 1.406, 1.039, 1.372, and 1.151, respectively. Compared to other adiposity indices, the WC had a significantly higher area under the curve (AUC) for predicting prehypertension (AUC: .619, sensitivity: 57%, specificity: 60.6%). In conclusion, WC and BMI might be the best indicators for prehypertension. Increasing evidence supports avoiding obesity as a preferred primary prevention strategy for prehypertension while controlling other major hypertension risk factors.
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Xiao et al. (2023) conducted a cross-sectional in Prehypertension in non-hypertensive Chinese adults (n=61,475). Adiposity indices (BMI, waist circumference, WHtR, BRI, ABSI, conicity index) vs. Normotensive status (<120/80 mmHg) and comparison across the six standardized adiposity indices was evaluated on Prehypertension prevalence (SBP 120-139 mmHg and/or DBP 80-89 mmHg) (OR 1.406, 95% CI 1.379-1.433, p=<0.001). Body mass index (adjusted OR 1.406, 95% CI 1.379-1.433) and waist circumference (OR 1.392, AUC 0.619) showed the strongest associations and discriminatory performance for prehypertension.
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