Fat distribution, body mass index and blood pressure in 22,090 men and women in the Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) study.
OBJECTIVE
To determine the relation between fat distribution and blood pressure, independent of body mass index.


METHODS
Cross-sectional, population-based study.


METHODS
Participants, 9936 men and 12,154 women aged 45-79 years, were recruited from general practices in Norfolk, United Kingdom for the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) study. Participants filled in a health and lifestyle questionnaire and their blood pressure and anthropometry were measured at a clinic. We mainly used waist-hip ratio (WHR) to assess body fat distribution.


RESULTS
Systolic blood pressure (SBP) and diastolic blood pressure (DBP) increased linearly across the whole range of waist-hip ratio in both men and women. The relation was independent of age, body mass index (BMI) and other covariates. Separately, waist and hip circumferences were positively related to SBP and DBP. When adjusted for BMI, waist circumference was positively related to SBP (in women) and DBP (in both men and women), whereas hip circumference was inversely related to SBP (but not DBP) in both men and women. Stratifying by tertiles of waist and hip circumference, age- and BMI-adjusted SBP and DBP were highest among those with high waist and small hip circumference measures.


CONCLUSIONS
Waist-hip ratio was independently related to blood pressure. Waist-hip ratio could reflect the separate and opposite relations of waist and hip circumferences on blood pressure. Characterizing patterns of fat distribution may have implications in the assessment and control of obesity-related blood pressure elevation.
Department of Public Health and Primary Care, University of Cambridge, Cambridge, MRC Dunn Human Nutrition Unit, Cambridge and MRC Epidemiology Unit, Cambridge, UK. dexter.canoy@srl.cam.ac.uk
Dexter
D
Canoy
Robert
R
Luben
Ailsa
A
Welch
Sheila
S
Bingham
Nicholas
N
Wareham
Nicholas
N
Day
Kay-Tee
KT
Khaw
D000005:Abdomen; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D049629:Waist-Hip Ratio