Parental History Lowers Body Mass Index Risk Cutoff for Hypertension among Urban Indian Adults

OBJECTIVE: Parental history of hypertension, a commonly occurring nonmodifiable genetic risk factor, was examined for its influence on cutoff for body mass index (BMI) for identifying risk of hypertension. DESIGN: Data on BMI, body fat (%), blood pressure (BP), parental history of hypertension, and lifestyle factors were collected through a cross-sectional study. SETTING: Pune City, Maharashtra, India. SUBJECTS: Urban Indian adults (330 men and 306 women, aged 30-60 years). RESULTS: Age-related increases in prevalence of obesity and of hypertension (BP ≥ 140/90 mmHg or antihypertensive medication) were significant (p < 0.01 for all) in both sexes. Among nonobese subjects, age-adjusted systolic (SBP) and diastolic (DBP) blood pressure levels were significantly (p < 0.01) higher for those with positive parental history than for those without parental history, in both sexes. Adjusted odds ratios showed that obesity or positive parental history when considered in isolation increased the risk of hypertension (by 3 times in men and 5 times in women), while the presence of both increased it further (by 4 times in men and 10 times in women), indicating their synergistic influence. Further, the BMI cutoff obtained from receiver operating characteristic (ROC) analysis was lower by 1 to 1.5 units for subjects with parental history than for those without parental history, across different levels of sensitivity. CONCLUSIONS: Positive parental history lowers the BMI risk cutoff for hypertension. The implication is that parental history could be an important aid in developing preventive strategy for timely and early screening of individuals at risk of hypertension in many Asian populations in similar settings.