title: Anthropometric indices as predictors of hypertension among men and women aged 40-69 years in the Korean population: the Korean Genome and Epidemiology Study.
abstract: BACKGROUND
  Obesity is one of the most significant risk factors for hypertension. However, there is controversy regarding which measure is the best predictor of hypertension risk. We compared body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) in subjects as predictive indicators for development of hypertension.
  
  
  METHODS
  The data were obtained from the Korean Genome and Epidemiology Study (KoGES), a large population-based prospective cohort study. A total of 4,454 subjects (2,128 men and 2,326 women) aged 40-69 years who did not have hypertension at baseline were included in this study. Incident hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or anti-hypertensive medication use during the 4-year follow up. Receiver operating characteristic (ROC) analysis was used to compare discrimination abilities for anthropometric indices for hypertension. Hazard ratios were calculated by Cox proportional hazard model with adjustment for age, smoking status, alcohol consumption, diabetes and family history of hypertension by sexes.
  
  
  RESULTS
  In men, the area under the ROC curve (AROC) was 0.62 for WC, WHR, and WHtR and 0.58 for BMI. In women, the AROCs for BMI, WC, WHR, and WHtR were 0.57, 0.66, 0.68, and 0.68, respectively. After adjustment for risk factors, a 1 standard deviation increase in BMI, WC, WHR, WHtR were significantly related to incident hypertension, respectively (hazard ratio: 1.39, 1.50, 1.40 and 1.49 in men, 1.31, 1.44, 1.35 and 1.48 in women).
  
  
  CONCLUSIONS
  The central obesity indices WC, WHR, and WHtR were better than BMI for the prediction of hypertension in middle-aged Korean people. WHtR facilitates prediction of incident hypertension because of the single standard regardless of sex, ethnicity, and age group. Therefore, WHtR is recommended as a screening tool for the prediction of hypertension.
authors.affiliation: Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, 361-951, Korea. joungwon@korea.kr.
authors.forename: Joung-Won
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, 361-951, Korea. namkyoo.lim@gmail.com.
authors.forename: Nam-Kyoo
authors.initials: NK
authors.lastname: Lim
authors.affiliation: Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, 361-951, Korea. komsol20th@hanmail.net.
authors.forename: Tae-Hwa
authors.initials: TH
authors.lastname: Baek
authors.affiliation: Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, 361-951, Korea. cell1@hanmail.net.
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Park
authors.affiliation: Division of Cardiovascular and Rare Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyeng 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, 361-951, Korea. mdhypark@gmail.com.
authors.forename: Hyun-Young
authors.initials: HY
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001837:Body Weights and Measures; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D056910:Republic of Korea; D012307:Risk Factors; D065927:Waist-Height Ratio