Key result
Waist-to-height ratio linked to ~30% higher odds of hypertension, outperforming other obesity metrics.
Why the study?
Which anthropometric obesity indicator has the highest diagnostic accuracy for identifying hypertension in Indonesian adults over 40 years of age?
Cross-Sectional (n=7,957)
Which anthropometric obesity indicator has the highest diagnostic accuracy for identifying hypertension in Indonesian adults over 40 years of age?
Odds Ratio: 1.3 (95% CI 1.17–1.44)
p-value: p=<0.001
Waist-to-height ratio is the most accurate and operationally feasible anthropometric screening indicator for hypertension risk in Indonesian adults, with optimal diagnostic cut-offs for BMI falling below current WHO Asia-Pacific standards.
WHtR may aid hypertension risk assessment beyond standard obesity metrics in adults >40; leaves open prospective validation before clinical adoption.
Obesity is a major risk factor for hypertension, yet the comparative diagnostic accuracy of different anthropometric obesity indicators for hypertension screening in Indonesian adults remains insufficiently characterised. This cross-sectional study analysed secondary data from the Indonesian Family Life Survey 5, including 7,957 adults aged >40 years (4,154 males; 3,803 females). Five obesity indicators, including body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio, and A Body Shape Index, were examined for their associations with hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg) using multivariable logistic regression and sex-stratified ROC curve analysis. The overall prevalence of hypertension was 32.6%, higher among females (34.7%) than males (30.7%). All five indicators were significantly associated with hypertension after adjustment for confounders (all p<0.001), with age identified as a universal confounder. WHtR demonstrated the strongest association (aOR=1.30, 95% CI: 1.17–1.44) and the highest adjusted AUC (0.6907). Sex-stratified analysis revealed that optimal diagnostic cut-off points differed meaningfully between males and females, with BMI thresholds below current WHO Asia-Pacific standards in both sexes. WHtR is recommended as the most balanced and operationally feasible screening indicator for hypertension risk in Indonesian adults.
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Oksidriyani et al. (2026) conducted a cross-sectional in Hypertension (n=7,957). Anthropometric obesity indicators (specifically waist-to-height ratio) was evaluated on Hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg) (aOR 1.30, 95% CI 1.17-1.44, p=<0.001). Waist-to-height ratio (WHtR) demonstrated the strongest association with hypertension among five obesity indicators in adults >40 years (aOR 1.30; 95% CI 1.17-1.44; P<0.001).
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