title: Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans.
abstract: 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.
authors.affiliation: Veterans Affairs Puget Sound Health Care System and the University of Washington, Seattle, Washington 98108, USA.
authors.forename: Tomoshige
authors.initials: T
authors.lastname: Hayashi
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: Donna L
authors.initials: DL
authors.lastname: Leonetti
authors.forename: Marguerite J
authors.initials: MJ
authors.lastname: McNeely
authors.forename: Laura
authors.initials: L
authors.lastname: Newell-Morris
authors.forename: Steven E
authors.initials: SE
authors.lastname: Kahn
authors.forename: Wilfred Y
authors.initials: WY
authors.lastname: Fujimoto
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin