Body mass index, abdominal adiposity and blood pressure: consistency of their association across developing and developed countries.
BACKGROUND
Obesity is increasing worldwide because developing countries are adopting Western high-fat foods and sedentary lifestyles. In parallel, in many of them, hypertension is rising more rapidly, particularly with age, than in Western countries.


OBJECTIVE
To assess the relationship between adiposity and blood pressure (BP) in a developing country with high average BP (The Seychelles, Indian Ocean, population mainly of African origin) in comparison to a developed country with low average BP (Switzerland, population mainly of Caucasian origin).


METHODS
Cross-sectional health examination surveys based on population random samples.


METHODS
The main Seychelles island (Mahé) and two Swiss regions (Vaud-Fribourg and Ticino).


METHODS
Three thousand one hundred and sixteen adults (age range 35-64) untreated for hypertension.


METHODS
Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), systolic and diastolic blood pressure (SBP and DBP, mean of two measures).


METHODS
Scatterplot smoothing techniques and gender-specific linear regression models.


RESULTS
On average, SBP and DBP were found to increase linearly over the whole variation range of BMI, WHR and WC. A modest, but statistically significant linear association was found between each indicator of adiposity and BP levels in separate regression models controlling for age. The regression coefficients were not significantly different between the Seychelles and the two Swiss regions, but were generally higher in women than in men. For the latter, a gain of 1.7 kg/m(2) in BMI, of 4.5 cm in WC or of 3.4% in WHR corresponded to an elevation of 1 mmHg in SBP. For women, corresponding figures were 1.25 kg/m(2), 2.5 cm and 1.8% respectively. Regression coefficients for age reflected a higher effect of this variable on both SBP and DBP in the Seychelles than in Switzerland.


CONCLUSIONS
These findings suggest a stable linear relation of adiposity with BP, independent of age and body fat distribution, across developed and developing countries. The more rapid increase of BP with age observed in the latter countries are likely to reflect higher genetic susceptibility and/or higher cumulative exposure to another risk factor than adiposity.
Doll
S
S
Institute for Social and Preventive Medicine, University of Lausanne, Switzerland.
Paccaud
F
F
Bovet
P
P
Burnier
M
M
Wietlisbach
V
V
D000005:Abdomen; D000328:Adult; D001794:Blood Pressure; D001823:Body Composition; D001824:Body Constitution; D015992:Body Mass Index; D019049:Developed Countries; D003906:Developing Countries; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D012737:Sex Factors; D012750:Seychelles / Q000453:epidemiology; D013557:Switzerland / Q000453:epidemiology