Can Anthropometric Indices Predict the Chance of Hypertension? A Multicentre Cross-Sectional Study in Iran

Objective: This study aims to assess the prevalence of hypertension (HTN) and determine the relationship between HTN and anthropometric indices including fat distribution, body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in Shiraz Heart Study. Design and method: Setting: In this cross-sectional study, subjects were enrolled in 25 clinics in Shiraz. I.R. Iran between 2019 and 2021. Participants: A total number of 7225 individuals were selected, aged between 40 and 70 years of whom 52.3% were female. Among the people living in Shiraz, individuals living far from clinics, cases of mental or physical disabilitiy and documented cardiovascular diseases were excluded. Primary and secondary outcome measures: Primary outcome: The association of body composition, WHR, WHtR and BMI with HTN. Secondary outcome: The sensitivity and specificity of the WHtR for the prediction of HTN. Results: A total number of 7225 adults were enrolled. HTN prevalence was 19.3%. Obesity prevalence was estimated to be 28.5%. WHR and lean body mass showed a significant association with HTN (p<0.05). Receiver operating characteristic for WHtR yielded an area under the curve of 0.62 (95% CI 0.61 to 0.64) and 0.63 (95% CI 0.62 to 0.65) for males and females, respectively. The optimal threshold value yielded 0.54 in men and 0.61 in women. The sensitivity was 72.3% and 73.9% in women and men, with specificity of 48.4% and 44.3%, respectively. Conclusions: HTN had a meaningful association with all the noted anthropometric indices. WHtR performed well as a predictor of HTN.