Anthropometric Indices in the Prediction of Hypertension in Female Adolescents

Abstract

Background: Identifying the best marker for appropriate screening of risk factors of chronic diseases seems necessary in any society. Objectives: This study aimed at performing a comparative evaluation of anthropometric indices to determine a better marker for prediction of high blood pressure in adolescents. Methods: This cross-sectional study was done during 2013 on 1046 students, aged 11 to 19 year old in Kashan, who were chosen by cluster and class sampling method. Height, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-high ratio (WHtR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) of the subjects were measured. Blood pressure of all subjects, who had their blood pressures measured during the first visit, was measured during the second and third visit again, and the three measured blood pressure averages was considered as subjects' blood pressure. Results: This study showed a significant positive correlation between BP and body mass index (BMI), WC, WHR, and WHtR indices (P < 0.001). Receiver operating characteristic curve (ROC) analysis was performed. Area under the curve (AUC) was obtained for BMI (0.62 to 0.73), WC (0.67 to 0.76), WHR (0.57 to 0.67), and WHtR (0.63 to 0.77) in diastolic blood pressure and BMI (0.66 to 0.76), WC (0.68 to 0.78), WHR (0.57 to 0.67) and WHtR (0.67 to 0.77) in systolic blood pressure. The WHtR in adolescents had better distinguishing power than other anthropometric indices. Conclusions: The WHtR, as a relatively simple, inexpensive, and convenient measurement method is the best anthropometric index for determination of blood pressure in these subjects.

Comparisons of body mass index, waist circumference, waist-to-height ratio and a body shape index (ABSI) in predicting high blood pressure among Malaysian adolescents: a cross-sectional study

“…The current study found that the optimal cut-off points of BMI, WC and WHtR for the prediction of high BP were lower than the threshold to define obesity in adolescents, replicating the results of previous studies 37 49. In the present study, the optimal WHtR cut-off values were 0.46 in men and 0.45 in women, which were close to the WHtR cut-off values (<0.5) reported by previous studies for the prediction of hypertension37 as well as metabolic syndrome50 and CVD risk among adolescents 51.…”

“…The current study found that the optimal cut-off points of BMI, WC and WHtR for the prediction of high BP were lower than the threshold to define obesity in adolescents, replicating the results of previous studies 37 49. In the present study, the optimal WHtR cut-off values were 0.46 in men and 0.45 in women, which were close to the WHtR cut-off values (<0.5) reported by previous studies for the prediction of hypertension37 as well as metabolic syndrome50 and CVD risk among adolescents 51. Although a WHtR of ≥0.5 was previously proposed as the universal cut-off value to assess abdominal obesity and cardiometabolic risk,14 the cut-off of 0.5 resulted in poor sensitivity in predicting CVD risk among adolescents and may not be efficiently used across different ethnic groups 52.…”

“…Studies found that BMI and WC were good predictors of elevated BP in adolescents 9 35. However, both indices exhibited low sensitivity in discriminating individuals with high BP 36 37. This could be due to the inability of BMI to measure fat distribution and differentiate adipose tissues and muscle mass.…”

Proposition of Cutoff Points for Anthropometric Indicators to Identify High Blood Pressure in Adolescents

“…Regarding the cutoff point for WHtR (>0.41) identified in this study for HBP screening in males, another study presented the same cutoff point of 0.41 ( 68 ). The cutoff point of 0.41 for WHtR is below cutoff points in other studies ( 21 , 23 , 63 , 65 , 66 , 69 – 71 ). Since 1995 ( 72 ), the year of the creation of anthropometric indicator WHtR, a universal cutoff point (0.50) has been established to identify overweight individuals from those with normal weight and to be considered a risk factor for cardiovascular diseases, among them, hypertension, which can be used for both sexes and different age and ethnic groups ( 72 , 73 ).…”

Prevalence of Obesity and Hypertension and Related Factors among Bank Employees in Zahedan, 2017

“…22 However, WHtR has been recommended as a simple screening tool and a more convenient indicator for assessing central adiposity, which could be superior to BMI and WC for the evaluation of cardiometabolic risk in both men and women. 23 In the present study, the prevalence rates of abdominal obesity based on WC and WHtR were 20.9% and 59.4%, respectively. These rates were higher in females when compared to males (35.2% and 18.2% vs. 81.5% and 55.4%, respectively).…”