title: Associations Between Hypertension and Body Mass Index and Waist Circumference in U.S. Adults: A Comparative Analysis by Gender.
abstract: BACKGROUND
  The body mass index (BMI) and waist circumference (WC) are a risk of hypertension, but their potentially multiplicative effect on hypertension is underexplored.
  
  
  OBJECTIVE
  To examine modifying effects of BMI and WC on hypertension using a nationally representative U.S. adult sample stratified by gender.
  
  
  METHODS
  Data were derived from the 2009-2010 NHANES. Overweight and obesity were based on BMI of 25.0-29.9 and ≥30 kg/m(2), respectively. High-risk WC was based on ≥102.0 and ≥88.0 cm for males and females, respectively. Hypertension was determined by systolic/diastolic blood pressure of ≥140/≥90 mmHg, or taking prescribed medications. Logistic regression was used to examine the association between hypertension and BMI and WC by gender. Interaction terms were added to examine if BMI modified the effect of WC on hypertension.
  
  
  RESULTS
  Both BMI and WC were significant predictors of hypertension in overall population. Gender-specific models indicated that BMI played an important role in hypertension risk among males, but WC in females. The interaction effects were present among males implying that the association of WC with hypertension was stronger if subjects were overweight or obese. This effect, however, was not present in females.
  
  
  CONCLUSIONS
  BMI and WC may influence hypertension differently among males and females.
authors.affiliation: Department of Public Health, College of Health and Human Services, Western Kentucky University, 1906 College Heights Blvd., Bowling Green, KY, 42101-1038, USA, ranjana.roka602@topper.wku.edu.
authors.forename: Ranjana
authors.initials: R
authors.lastname: Roka
authors.forename: Akihiko
authors.initials: A
authors.lastname: Michimi
authors.forename: Gretchen
authors.initials: G
authors.lastname: Macy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology*; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference; D055815:Young Adult