title: Age and sex-specific associations of anthropometric measures of adiposity with blood pressure and hypertension in India: a cross-sectional study.
abstract: A determinant of blood pressure is adiposity; however, there are uncertainties surrounding whether general or central adiposity is the more important determinant of blood pressure. Further, inconsistent results exist for the relationships of anthropometric measures with blood pressure and hypertension, and whether these relationships differ substantially by age and sex is unclear. We aimed to elucidate the associations of anthropometric measures of general and central adiposity with blood pressure and hypertension, and determine the effect of age and sex on these relationships.
  
  
  
  We used cross-sectional data from the Centre for Global Health Research health check-up survey conducted during 2006-2007 of the general population in India (n = 7 601; age 18-59 years). We examined the associations of anthropometric measures (body mass index, waist circumference, hip circumference, waist-hip ratio, waist-height ratio) with blood pressure components (systolic pressure, diastolic pressure, pulse pressure, mean arterial pressure, mid-blood pressure) and hypertension within four (18-29 years, 30-39 years, 40-49 years, 50-59 years) age groups, by sex. We adjusted all analyses for education and location, with further adjustments, variously, for either a measure of central (waist circumference) or general (body mass index) adiposity.
  
  
  
  On average, every 5 kg/m2greater body mass index or 10 cm wider waist circumference was associated with a 5 and 4 mmHg higher systolic blood pressure, respectively. When considered separately, each anthropometric measure was strongly and positively associated with most blood pressure components in all age groups, and for both sexes. However, with few exceptions, when considered jointly (body mass index adjusted for waist circumference), the associations of body mass index with blood pressure components and hypertension were greatly diminished for both sexes, and particularly in the ≥30 years age groups. By contrast, further adjustment of waist circumference for body mass index did not materially alter the associations of waist circumference with blood pressure components and hypertension.
  
  
  
  Our findings indicate that central adiposity, as assessed with anthropometric measures, may be a more important determinant of blood pressure and hypertension than general adiposity for adults in India.
authors.affiliation: Centre for Global Health Research, St. Michael's Hospital, Toronto, ON, Canada. kevin.taing@utoronto.ca.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. kevin.taing@utoronto.ca.
authors.forename: Kevin Y
authors.initials: KY
authors.lastname: Taing
authors.affiliation: Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.|The Heart and Stroke Richard Lewar Centre of Excellence in Cardiovascular Research, University of Toronto, Toronto, ON, Canada.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Farkouh
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Rahim
authors.initials: R
authors.lastname: Moineddin
authors.affiliation: Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.|Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
authors.forename: Jack V
authors.initials: JV
authors.lastname: Tu
authors.affiliation: Centre for Global Health Research, St. Michael's Hospital, Toronto, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Prabhat
authors.initials: P
authors.lastname: Jha
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000886:Anthropometry / Q000379:methods*; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D011159:Population Surveillance; D012189:Retrospective Studies; D012737:Sex Factors; D055815:Young Adult
keywords: Adiposity; Age; Anthropometry; Blood pressure; Body mass index; Hypertension; India; Sex; Waist circumference