Are Race Differences in the Prevalence of Hypertension Explained by Body Mass and Fat Distribution? A Survey in a Biracial Population

Lackland, Daniel T.; Orchard, Trevor J.; Keil, Julian; Saunders, Donald E.; Wheeler, Frances C.; Adams‐Campbell, Lucile L.; McDonald, Robert H.; Knapp, Rebecca G.

doi:10.1093/ije/21.2.236

Cited by 73 publications

(53 citation statements)

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“…Similar results were observed in the Curaçao Health Study, except that among men the decrease of mean BMI, WHR and WC already set in after the age of 65 y (Grol et al, 1997). Studies among westernised populations show that the prevalence of both overall and central obesity increases with age to about 60-65 y and then declines (Lackland et al, 1992; Obesity in the Netherlands Antilles L Grievink et al Seidell & Visscher, 2000). Compared to Western populations, men as well as women in these three islands of the Netherlands Antilles remain obese until an older age.…”

Section: Discussionsupporting

confidence: 79%

Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus

et al. 2004

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Objectives: To evaluate waist circumference (WC) as a screening tool for obesity in a Caribbean population. To identify risk groups with a high prevalence of (central) obesity in a Caribbean population, and to evaluate associations between (central) obesity and self-reported hypertension and diabetes mellitus. Design: Cross-sectional. Setting: Population-based study. Subjects: A random sample of adults (18 y or older) was selected from the Population Registries of three islands of the Netherlands Antilles. Response was over 80%. Complete data were available for 2025 subjects. Intervention: A questionnaire and measurements of weight, height, waist and hip. Main outcome measurement: Central obesity indicator (WC Z102 cm men, Z88 cm women). Results: WC was positively associated with age (65-74 y vs 18-24 y) in men (OR ¼ 7.7, 95% CI 3.4-17.4) and women (OR ¼ 6.4, 95% CI 3.2-12.7). Women with a low education had a higher prevalence of central obesity than women with a high education (OR ¼ 0.5, 95% CI 0.3-0.7). However, men with a high income had a higher prevalence of a central obesity than men with a low income (OR ¼ 1.7, 95% CI ¼ 1.1-2.6). WC was the strongest independent obesity indicator associated with self-reported hypertension (OR ¼ 1.7, 95% CI 1.4-2.0) and diabetes mellitus (OR ¼ 1.6, 95% CI 1.3-1.9). Conclusions: The identified risk groups were women aged 55-74 y, women with a low educational level and men with a high income. WC appears to be the major obesity indicator associated with hypertension and diabetes mellitus.

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Section: Discussionsupporting

confidence: 79%

Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus

et al. 2004

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“…The ®nding that the WHR increases with age is in line with other studies. 11,12 Mean WC among women is much higher than reported in other studies. 11,29 Figure 4 Prevalence of obesity (body mass index (BMI) !…”

Section: Comparisonsmentioning

confidence: 61%

“…Abdominal fatness in Curac Ëao is comparable to that found in a study in a biracial population carried out in the United States. 12 Compared to a study which reports results from four different European countries, the mean WHR among Curac Ëao women is much higher (0.79 vs 0.83). The ®nding that the WHR increases with age is in line with other studies.…”

Section: Comparisonsmentioning

confidence: 68%

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Alarmingly high prevalence of obesity in Curaçao: data from an interview survey stratified for socioeconomic status

et al. 1997

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OBJECTIVE: The aim of the article is to report the prevalence of obesity, abdominal fatness and waist circumference in different socioeconomic classes in Curac Ë ao. DESIGN: In 1993/1994 a health interview survey (the Curac Ë ao Health Study) was carried out among a random sample (n 2248, response rate 85%) of the adult non-institutionalized population of Curac Ë ao. METHODS: We analyzed the association between obesity (BMI ! 30), abdominal fatness (waist hip ratio (WHR) ! 0.95 for men, WHR ! 0.80 for women) waist circumference (WC ! 100 cm for men, WC ! 91 cm for women) and socioeconomic status (SES) by age adjusted logistic regressions, for men and women separately. RESULTS: The prevalence of obesity was about 27%: 36% of the women and 19% of the men were obese. An at risk WHR was reported among 62.2% of the women and among 20.4% of the men. A WC above the cut-off point was reported for 44.3% women and 25.3% men. Compared to women of higher SES, the lower SES women have a two to three times higher risk of a BMI, WHR or WC exceeding the cut-off points. Among men, no statistically signi®cant difference between an increased BMI, WHR or WC and SES factors was found. The overlap between the three measures is large, about 56% of the women scored similarly on all three measurements. Among men the overlap is even greater (73%). CONCLUSIONS: The prevalence of obesity in Curac Ë ao is alarming. Low SES women are at the greatest risk of an increased BMI, WHR or WC. The obesity ®gures can be placed between industrialized societies and less modernized cultures. Action and additional research on the prevention of obesity in Curac Ë ao are deemed necessary. The cut-off points in our study for WC in the non-white population are preliminary and need to be elucidated further.

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“…This is in agreement with previous data where raised blood pressure and an increased prevalence of HT have been observed to be related to both general obesity and fat distribution. 34 External neck circumference is increased in sleep apnoea and it has been suggested that this measurement explains most or all of the link between obesity and sleep apnoea. 35 36 However, when adjusting for neck circumference in our study, DI >10 and lowest desaturation were still independent predictors of HT, indicating that the association between SDB and HT cannot be explained only by an interrelationship with fat distribution.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of sleep apnoea and snoring in hypertensive men: a population based study

Sjöström

Lindberg²,

Elmasry³

et al. 2002

Thorax

120

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Background: Several studies have reported an association between sleep disordered breathing (SDB) and hypertension (HT) but there is still a debate as to whether this is an effect of confounders. Some researchers have found an age dependent relationship between SDB and HT with higher risk at lower ages. A case-control study was performed in hypertensive men and non-hypertensive male controls matched for age and body mass index to assess whether there is an independent association between SDB and HT. If so, we further wanted to investigate whether this effect is age dependent. Methods: An overnight sleep study was performed in a population based, age stratified sample of 102 hypertensive men aged 43-82 years and 102 non-hypertensive controls. Results: Hypertensive subjects had a significantly higher prevalence of SDB than non-hypertensive subjects (apnoea-hypopnoea index (AHI): 10.8 v 7.3; desaturation index (DI): 8.5 v 5.2; AHI >10: 37% v 24%, p<0.05; DI >10: 29% v 12%; lowest desaturation: mean (SD) 81.9 (7.3) v 84.7 (6.1), p<0.01). After adjusting for neck circumference and physical inactivity, DI >10 and lowest desaturation were still independent predictors of HT with adjusted odds ratios of 2.3 (95% CI 1.0 to 5.3) and 0.94 (95% CI 0.89 to 0.99), respectively. When the subjects were split into two groups according to age (<60 and >60 years), the influence of DI >10 on HT was strongest in the younger men (adjusted OR 4.3 (95% CI 1.0 to 19.3 v 2.1 (95% CI 0.7 to 6.5)) and the association between minimum oxygen saturation (SaO 2 ) and HT reached statistical significance in the younger men only. Conclusion: SDB is more prevalent in men with HT than in controls. DI >10 and lowest desaturation are independent predictors of HT irrespective of confounders. The results indicate that the influence of SDB on HT is more pronounced in younger and middle aged men than in those above 60 years.

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Are Race Differences in the Prevalence of Hypertension Explained by Body Mass and Fat Distribution? A Survey in a Biracial Population

Cited by 73 publications

References 0 publications

Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus

Waist circumference as a measurement of obesity in the Netherlands Antilles; associations with hypertension and diabetes mellitus

Alarmingly high prevalence of obesity in Curaçao: data from an interview survey stratified for socioeconomic status

Prevalence of sleep apnoea and snoring in hypertensive men: a population based study

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