Blood pressure in relation to general and central adiposity among 500 000 adult Chinese men and women.
BACKGROUND
Greater adiposity is associated with higher blood pressure. Substantial uncertainty remains, however, about which measures of adiposity most strongly predict blood pressure and whether these associations differ materially between populations.


METHODS
We examined cross-sectional data on 500 000 adults recruited from 10 diverse localities across China during 2004-08. Multiple linear regression was used to estimate the effects on systolic blood pressure (SBP) of general adiposity [e.g. body mass index (BMI), body fat percentage, height-adjusted weight] vs central adiposity [e.g. waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR)], before and after adjustment for each other. The main analyses excluded those reported taking any antihypertensive medication, and were adjusted for age, region and education.


RESULTS
The overall mean [standard deviation (SD)] BMI was 23.6 (3.3) kg/m(2) and mean WC was 80.0 (9.5) cm. The differences in SBP (men/women, mmHg) per 1SD higher general adiposity (height-adjusted weight: 6.6/5.6; BMI: 5.5/4.9; body fat percentage: 5.5/5.0) were greater than for central adiposity (WC: 5.0/4.3; HC: 4.8/4.1; WHR: 3.7/3.2), with a 10 kg/m(2) greater BMI being associated on average with 16 (men/women: 17/14) mmHg higher SBP. The associations of blood pressure with measures of general adiposity were not materially altered by adjusting for WC and HC, but those for central adiposity were significantly attenuated after adjusting for BMI (WC: 1.1/0.7; HC: 0.3/-0.2; WHR: 0.6/0.6).


CONCLUSIONS
In adult Chinese, blood pressure is more strongly associated with general adiposity than with central adiposity, and the associations with BMI were about 50% stronger than those observed in Western populations.
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK, zhengming.chen@ctsu.ox.ac.uk lmlee@vip.163.com.
Zhengming
Z
Chen
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Margaret
M
Smith
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Huaidong
H
Du
Chinese Academy of Medical Sciences, Beijing, China.
Yu
Y
Guo
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Robert
R
Clarke
Chinese Academy of Medical Sciences, Beijing, China.
Zheng
Z
Bian
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Rory
R
Collins
China National Centre for Food Safety Risk Assessment, Beijing, China.
Junshi
J
Chen
Tongxiang Centre for Disease Control and Prevention (CDC), Zhejiang, China.
Yijian
Y
Qian
Maiji CDC, Gansu, China.
Xiaoping
X
Wang
Sichuan Provincial CDC, Chengdu, China.
Xiaofang
X
Chen
Qingdao CDC, Qingdao, China.
Xiaocao
X
Tian
Hainan Provincial CDC, Haikou, China and.
Xiaohuan
X
Wang
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Richard
R
Peto
Chinese Academy of Medical Sciences, Beijing, China, Department of Epidemiology & Biostatistics, Peking University, Beijing, China zhengming.chen@ctsu.ox.ac.uk lmlee@vip.163.com.
Liming
L
Li
D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000368:Aged; D044466:Asian People; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D015992:Body Mass Index; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio
Adiposity; Chinese; blood pressure; cross-sectional studies; epidemiology