Abdominal adiposity in six populations of West African descent: prevalence and population attributable fraction of hypertension.
OBJECTIVE
The objective of this investigation was to examine the prevalence of abdominal adiposity and its association with the prevalence of hypertension among African descent populations in Nigeria, Cameroon, Jamaica, St. Lucia, Barbados, and the United States (US).


METHODS
The data for this investigation were obtained from the International Collaborative Study on Hypertension in Blacks. Hypertension was defined as mean diastolic blood pressure > or =90 mmHg, systolic blood pressure > or = 140 mmHg or current treatment with prescribed anti-hypertension medication. Abdominal overweight was defined as waist circumference (WC) > or =94 and > or =80 cm for men and women, respectively. Abdominal obesity was defined as WC > or =102 and > or =88 cm for men and women, respectively. We estimated the site-specific prevalence of abdominal overweight and obesity across age and body mass index cut-points. We also calculated the population attributable fraction (AF) of hypertension due to abdominal adiposity.


RESULTS
The prevalence of hypertension in these populations was tightly linked to abdominal adiposity. Increases in abdominal overweight accompanied an increasing degree of Westernization, rising from 6.4% and 26.3% in Nigeria, 16.5% and 62.8% in Cameroon, 15.8% and 58.6% in Jamaica, 14.3% and 62.1% in St. Lucia, 21.4% and 70.3% in Barbados to 38.9%, and 76.4% in the US for men and women, respectively. The corresponding values for abdominal obesity were 1.6% and 12.3% in Nigeria, 5.1% and 38.9% in Cameroon, 5.5% and 34.0% in Jamaica, 2.7% and 40.7% in St. Lucia, 7.8% and 44.7% in Barbados to 21.7% and 54.1% in the US for men and women, respectively. Body mass index-adjusted estimates of AF suggest that in most of these populations, especially in females, avoidance of abdominal overweight or obesity would help to curb the development of hypertension.


CONCLUSIONS
An important public health challenge is to clarify how lifestyle factors influence risks of abdominal adiposity and ultimately the increased risk of cardiovascular diseases.
Okosun
I S
IS
Department of Preventive Medicine and Epidemiology, Loyola University Medical Center, Stritch School of Medicine, Maywood, IL 60153, USA. iokosun@luc.edu
Forrester
T E
TE
Rotimi
C N
CN
Osotimehin
B O
BO
Muna
W F
WF
Cooper
R S
RS
D000005:Abdomen; D000273:Adipose Tissue; D000328:Adult; D000354:Africa, Western / Q000208:ethnology; D000368:Aged; D001460:Barbados / Q000453:epidemiology; D001823:Body Composition; D001824:Body Constitution; D015992:Body Mass Index; D002163:Cameroon / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D019431:Saint Lucia / Q000453:epidemiology; D014481:United States / Q000453:epidemiology