title: Association of visceral and total body fat with hypertension and prehypertension in a middle-aged Chinese population.
abstract: OBJECTIVE
  This article investigates the relative effects of percentage body fat (PBF) and visceral fat index (VFI) on the prevalence of hypertension and prehypertension, and evaluates if excess visceral deposition of body fat increased the risk of hypertension or prehypertension.
  
  
  METHODS
  A general population-based sample of men (n = 5297) and women (n = 6232), aged 35-64 years, was studied. Based on blood pressure (BP) levels, normotensive, prehypertensive, and hypertensive study participants were identified. Multivariate linear regression models with SBP or DBP as a dependent variable and multivariate ordinal logistic regression models with BP categories as a dependent variable were performed.
  
  
  RESULTS
  In the normotensive, prehypertensive, and hypertensive participants, the mean (standard deviation) PBF was 27.83 (6.85), 28.91 (6.65), and 30.2 (6.73), respectively, whereas VFI was 6.97 (3.78), 8.89 (4.35), and 10.75 (5.05), respectively. After adjusting for age, smoking, alcohol consumption, education, regions (north or south), areas (urban or rural), diabetes, and family history, PBF and VFI (in separate models) showed a strong positive association with hypertension or prehypertension (P < 0.0001). However, when both PBF and VFI were adjusted for in the same multivariate model, VFI but not PBF remained positively associated with hypertension and prehypertension for both genders (P < 0.0001). A similar positive association was reported with the VFI/PBF ratio (P < 0.0001).
  
  
  CONCLUSIONS
  As excess visceral body fat is strongly associated with higher risk of hypertension and prehypertension, measurements of VFI or VFI/PBF ratio, in addition to PBF, will provide a better understanding of adiposity-related risks for hypertension and prehypertension.
authors.affiliation: aDivision of Prevention and Community Health, National Center for Cardiovascular Diseases, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences bSchool of Statistics, Renmin University of China, Beijing, China *Zengwu Wang and Xianbin Zeng contributed equally to the writing of this article.
authors.forename: Zengwu
authors.initials: Z
authors.lastname: Wang
authors.forename: Xianbin
authors.initials: X
authors.lastname: Zeng
authors.forename: Zuo
authors.initials: Z
authors.lastname: Chen
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Linfeng
authors.initials: L
authors.lastname: Zhang
authors.forename: Manlu
authors.initials: M
authors.lastname: Zhu
authors.forename: Danhui
authors.initials: D
authors.lastname: Yi
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D001794:Blood Pressure; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D058246:Prehypertension / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors