Cut-off points for anthropometric indices to screen for hypertension among Iranian adults of the Bandare-Kong cohort: a cross-sectional study

Background

Obesity is one of the major determinants of blood pressure. This study aimed to determine the optimal sex- and age-specific cut-off points of anthropometric indices, including body mass index (BMI), waist circumference (WC), hip circumference (HC), wrist circumference (WrC), waist-hip ratio (WHR), and waist-height ratio (WHtR), to screen for hypertension (HTN) in a cohort of Iranian adults aged 35 to 70 years, and to compare the predictive performance of the indices based on receiver operating characteristic (ROC) curves.

Methods

This population-based study was carried out on the participants aged 35 to 70 years of the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study, a part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). Using the area under the receiver operating characteristic curve (AUC) and Youden's J index, optimal sex- and age-specific cut-off points of the anthropometric indices in association with HTN were calculated.

Results

This study included a total of 2256 females and 1722 males. HTN was diagnosed in 736 females (32.6%) and 544 males (31.6%). The optimal cut-off of WC for HTN was 90 cm in males and 95 cm in females, with an area under the ROC curve (AUROC) of 0.60 and 0.64, respectively. For HC, the optimal cut-off was 95 cm for males and 108 cm for females (AUROC = 0.54 for both). Moreover, WrC optimal cut-offs were 17 cm for males (AUROC = 0.56) and 15 cm for females (AUROC = 0.57). As for BMI, the optimal cut-off was 25 kg/m² in males and 27 kg/m² in females (AUROC of 0.59 and 0.60, respectively). Also, a cut-off of 0.92 was optimal for WHR in males (AUROC = 0.64) and 0.96 in females (AUROC = 0.67). On the other hand, WHtR optimal cut-offs were 0.52 for males and 0.60 for females (AUROC of 0.63 and 0.65, respectively).

Conclusions

WHR and WHtR, as anthropometric indices of obesity, were demonstrated to be significant predictors of HTN. Further, we suggest using WHR (cut-off point of 0.92 for males and 0.96 for females) and WHtR (cut-off point of 0.52 for males and 0.60 for females) as measures of preference to predict HTN among the southern Iranian population. Further multicenter longitudinal studies are recommended for a more accurate prediction of HTN.

Association of obesity anthropometric indices with hypertension, diabetes mellitus and hypertriglyceridemia in apparently healthy adult Nigerian population

BACKGROUND

Hypertension, hyperglycemia and hypertriglyceridemia are chronic conditions associated with cardiometabolic diseases. Certain anthropometric indices are known to predict them.

AIM

To investigate the association of anthropometric indices with these chronic diseases and which anthropometric index predicts them best.

METHODS

In this study, 221 apparently healthy individuals who never received treatments for cardiovascular disease (CVD), diabetes or other chronic diseases participated. The age of the participants ranged from 20-75 years with mean age of 36.9 ± 11.4 years. The risk factors of these diseases namely systolic blood pressures (SBP) and diastolic blood pressures (DBP), fasting blood glucose (FBG) and triglycerides (TG) were determined for all the participants using standard clinical procedures. The obesity anthropometric indices, waist circumference, waist-to-height ratio, waist-to-hip ratio and body mass index as well as abdominal height (AH) and body surface index were determined. The association between each of them with the risk factors were determined by the Pearson correlation method.

RESULTS

From the results, it was found that AH showed superiority over the rest for SBP (r = 0.301, P < 0.01), DBP (r = 0.370, P < 0.01), FBG (r = 0.297, P < 0.01) and TG (r = 0.380, P < 0.01). Using the receiver operating characteristic curves, cut-off values of AH for SBP, DBP, FBG and TG were determined to be 24.75 cm, 24.75 cm, 25.25 cm and 24.75 cm respectively.

CONCLUSION

The indices of anthropometry used in this study correlated significantly with the studied CVD risk factors, with AH emerging as the most predictive.

Hypertension and pre-hypertension in Middle East and North Africa (MENA): A meta-analysis of prevalence, awareness, treatment, and control

Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact prevalence of prehypertension (pre-HTN) and HTN in the Middle East and North Africa (MENA) is lacking. This meta-analysis was conducted to evaluate prevalence of pre-HTN and HTN, awareness, treatment, and control in the MENA region. PubMed, Web of Science, and Scopus databases were searched from inception to April 30, 2021. Keywords included hypertension, pre-hypertension, awareness, treatment, and control. The quality of the included studies was evaluated using the Hoy scale. A random-effects model was evaluated based on overall HTN. The heterogeneity of the preliminary studies was evaluated using the I² test. A total of 147 studies involving 1,312,244 participants were included in the meta-analysis. Based on the results of the random-effects method (95% CI), the Prevalence of pre-HTN and HTN were 30.6% (95% CI: 25.2, 36.0%; I² = 99.9%), and 26.2% (95% CI: 24.6, 27.9%; I² = 99.8%), respectively. The prevalence of HTN awareness was 51.3% (95% CI: 47.7, 54.8; I² = 99.0%). The prevalence of HTN treatment was 47.0% (95% CI: 34.8, 59.2; I² = 99.9%). The prevalence of HTN control among treated patients was 43.1% (95% CI: 38.3, 47.9; I² = 99.3%). Considering the high prevalence of HTN, very low awareness, and poor HTN control in the region, more attention should be paid to preventive programs for HTN reduction.

Waist-To-Height Ratio Is a More Accurate Tool for Predicting Hypertension Than Waist-To-Hip Circumference and BMI in Patients With Type 2 Diabetes: A Prospective Study

Background: Anthropometric measures [i.e., body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)] have been used as prediction factors for incident hypertension. However, whether any of these measures is superior to another in the matter of accuracy in predicting hypertension in diabetic patients has been controversial. The present prospective study aimed to determine whether WHtR is a more accurate tool for predicting hypertension than WHR and BMI in patients with type 2 diabetes.

Methods: The study population consisted of 1,685 normotensive patients with type 2 diabetes. BMI, WHR, and WHtR were assessed at baseline and followed up for hypertension incidence for a mean of 4.8 years. A cox regression analysis was performed to assess the association between anthropometric measures (i.e., BMI, WHR, and WHtR) and incident hypertension during the follow-up period. The area under the ROC curve analysis was performed and optimal cutoff values were calculated for each anthropometric measure for hypertension prediction.

Results: WHtR and BMI were significantly associated with an increased incidence of hypertension (HR = 3.296 (0.936–12.857), P < 0.001, and HR = 1.050 (1.030–1.070), P < 0.001, respectively). The discriminative powers for each anthropometric index for hypertension were 0.571 (0.540–0.602) for BMI, 0.518 (0.486–0.550) for WHR, and 0.609 (0.578–0.639) for WHtR. The optimal cutoff points for predicting hypertension in patients with type 2 diabetes were 26.94 (sensitivity = 0.739, specificity = 0.380) for BMI, 0.90 (sensitivity = 0.718, specificity = 0.279) for WHR, and 0.59 (sensitivity = 0.676, specificity = 0.517) for WHtR.

Conclusion: WHtR was a more accurate tool for predicting hypertension compared to WHR and BMI in patients with type 2 diabetes.

Association of anthropometric indices of obesity with hypertension among public employees in northern Ethiopia: findings from a cross-sectional survey

OBJECTIVES

The burden of hypertension is increasing in low-income countries, including Ethiopia. Obesity is widely known to be associated with hypertension, but different anthropometric indices of obesity might differ in association with hypertension, which is largely unknown in northern Ethiopia.

DESIGN

Data from our previous cross-sectional epidemiological survey were statistically analysed.

SETTING

Public employees in the regional capital city in northern Ethiopia.

PARTICIPANTS

The data of 1380 participants (823 men and 557 non-pregnant women) aged 25 and 64 years were analysed.

OUTCOME MEASURES

The presence of hypertension was the outcome measure and multivariable-adjusted logistic regression analyses were used to investigate the association of body mass index (BMI), waist circumference, and waist-hip ratio in men and women separately. The area under the curve (AUC) for three anthropometric indices for discriminating hypertension was also obtained. Separate analyses were conducted for waist circumference and waist-hip ratio analyses further adjusted for BMI.

RESULTS

BMI was linearly associated with hypertension in men (OR for 1 SD increase in BMI 1.45, p=0.001) and women (OR for 1 SD increase in BMI 1.41, p=0.01). The association of waist circumference was independent of BMI both in men (OR for 1 SD increase in waist circumference: 1.74, p=0.002) and women (OR for 1 SD increase in waist circumference: 1.57, p=0.029). The association of waist-hip ratio with hypertension adjusted for BMI was significant in men (OR for 1 SD increase in the waist-hip ratio: 1.46, p<0.001), but was weak and non-significant in women. The AUC for BMI was 0.64 in men and 0.67 in women, while AUC for waist circumference was 0.69 both in men and women.

CONCLUSIONS

Waist circumference was associated with hypertension independent of BMI among public employees in northern Ethiopia.

Faktor yang Berhubungan dengan Konsumsi Energi Ibu Menyusui di Kecamatan Cipayung, Kota Depok, Indonesia

Latar Belakang: Untuk mendukung kebutuhan gizi yang tinggi saat menyusui, ibu menyusui membutuhkan lebih banyak energi dibandingkan ibu hamil. Namun, berbagai studi melaporkan bahwa konsumsi energi ibu menyusui justru lebih rendah dibandingkan ibu hamil.Tujuan: Mengetahui faktor yang berhubungan dengan konsumsi energi ibu menyusui yang rendah di Kecamatan Cipayung Kota Depok Tahun 2016.Metode: Penelitian ini menganalisis data sekunder dari penelitian eksperimental semu dengan pendekatan kohort prospektif di Kota Depok. Total sampel berjumlah 169 responden. Analisis data pada penelitian ini menggunakan uji chi-square dan uji regresi logistik ganda.Hasil:  Konsumsi energi ibu saat hamil merupakan faktor dominan yang berhubungan dengan konsumsi energi ibu saat menyusui setelah dikontrol dengan paritas dan usia ibu. Ibu yang mengonsumsi energi dalam jumlah kurang saat hamil berisiko 3,5 kali lebih besar untuk mengonsumsi energi dalam jumlah kurang saat menyusui.Kesimpulan: Konsumsi energi ibu hamil sangat penting diperhatikan karena selain diperlukan untuk pertumbuhan dan perkembangan janin, sebagai cadangan lemak yang akan digunakan saat menyusui, juga untuk menjamin agar ibu mengonsumsi energi dalam jumlah cukup saat menyusui.