title: Moderate waist circumference and hypertension prevalence: the REGARDS Study.
abstract: BACKGROUND
  High waist circumference (WC) (women: >88 cm; men: >102 cm) increases cardiovascular risk. Less is known about moderate WC (women: 80-88 cm; men: 94-102 cm). Therefore, we examined the association between moderate WC and hypertension prevalence, independent of body mass index (BMI).
  
  
  METHODS
  Among 24,247 eligible adults 45-84 years old, when recruited from January 2003 to October 2007 in the population-based REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort, we examined hypertension prevalence (systolic blood pressure (BP) ≥140 mm Hg, or diastolic BP ≥90 mm Hg, or self-reported antihypertensive medication use) by WC before and after stratification by BMI (normal: 18.5-24.9; overweight: 25-29.9; obese class I: 30-34.9). Logistic regression adjusted associations between WC, BMI, and hypertension prevalence for age, race, sex, region, income, education, cigarette smoking, glomerular filtration rate, alcohol use, and physical activity.
  
  
  RESULTS
  Overall, hypertension prevalence was 44% among those with low WC (n = 8,068), 55% with moderate WC (n = 6,488), and 66% with high WC (n = 9,691). After full adjustment, moderate WC was independently associated with hypertension prevalence among persons with normal BMI, (adjusted odds ratio (aOR), 1.49; 95% confidence interval (CI), 1.31-1.70), overweight BMI (aOR, 1.80; 95% CI, 1.64-1.98), and obese class I BMI (aOR, 2.28; 95%CI, 1.96-2.65) (referent: low WC-normal BMI). The moderate WC-hypertension association was observed in blacks and whites and in men and women.
  
  
  CONCLUSIONS
  Moderate WC is associated with hypertension prevalence independent of BMI and several hypertension risk factors in middle-aged and older adults.
authors.affiliation: VA Ann Arbor Healthcare System, and Departments of Medicine and Neurology, University of Michigan, Ann Arbor, MI, USA. deblevin@umich.edu
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Levine
authors.forename: David A
authors.initials: DA
authors.lastname: Calhoun
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Prineas
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Howard
authors.forename: George
authors.initials: G
authors.lastname: Howard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D015144:Southeastern United States / Q000453:epidemiology; D055105:Waist Circumference; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American