Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans.
BACKGROUND
Visceral adiposity is generally considered to play a key role in the metabolic syndrome.


OBJECTIVE
To examine the relationship between directly measured visceral adiposity and the risk for incident hypertension, independent of other adipose depots and fasting plasma insulin levels.


METHODS
Community-based prospective cohort study with 10- to 11-year follow-up.


METHODS
King County, Washington.


METHODS
300 Japanese Americans with a systolic blood pressure less than 140 mm Hg and a diastolic blood pressure less than 90 mm Hg who were not taking antihypertensive medications, oral hypoglycemic medications, or insulin at study entry.


METHODS
Abdominal, thoracic, and thigh fat areas were measured by using computed tomography. Total subcutaneous fat area was calculated as the sum of these fat areas excluding the intra-abdominal fat area. Hypertension during follow-up was defined as having a systolic blood pressure of 140 mm Hg or greater, having a diastolic blood pressure of 90 mm Hg or greater, or taking antihypertensive medications.


RESULTS
There were 92 incident cases of hypertension during the follow-up period. The intra-abdominal fat area was associated with an increased risk for hypertension. Multiple-adjusted odds ratios of hypertension for quartiles of intra-abdominal fat area (1 = lowest; 4 = highest) were 5.07 (95% CI, 1.75 to 14.73) for quartile 3 and 3.48 (CI, 1.01 to 11.99) for quartile 4 compared with quartile 1 after adjustment for age, sex, fasting plasma insulin level, 2-hour plasma glucose level, body mass index, systolic blood pressure, alcohol consumption, smoking status, and energy expenditure through exercise (P = 0.003 for quadratic trend). The intra-abdominal fat area remained a significant risk factor for hypertension, even after adjustment for total subcutaneous fat area, abdominal subcutaneous fat area, or waist circumference; however, no measure of these fat areas was associated with risk for hypertension in models that contained the intra-abdominal fat area.


CONCLUSIONS
It is not known whether these results pertain to other ethnic groups.


CONCLUSIONS
Greater visceral adiposity increases the risk for hypertension in Japanese Americans.
Hayashi
Tomoshige
T
Veterans Affairs Puget Sound Health Care System and the University of Washington, Seattle, Washington 98108, USA.
Boyko
Edward J
EJ
Leonetti
Donna L
DL
McNeely
Marguerite J
MJ
Newell-Morris
Laura
L
Kahn
Steven E
SE
Fujimoto
Wilfred Y
WY
D000005:Abdomen / Q000473:pathology*; D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D000368:Aged; D001213:Asian; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000473:pathology*; D011446:Prospective Studies; D012307:Risk Factors
D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin