BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital outpatients: a cross-sectional, non-inferiority study

Shrestha, Rajan; Upadhyay, Sanjib Kumar; Khatri, Bijay; Bhattarai, Janak R.; Kayastha, Manish; Upadhyay, Madan Prasad

doi:10.1136/bmjopen-2021-050096

Cited by 20 publications

(29 citation statements)

References 33 publications

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“…In contrast, the waist height ratio was a male risk predictor among elderly Egyptian individuals (11). Shrestha and colleagues have shown that BMI, waist-to-height ratio, and waist circumference are linked with hypertension and can use as a screening tool for hypertension in low-income countries (12). Our results are like these studies.…”

Section: Discussionsupporting

confidence: 76%

The relation between obesity and hypertension

Colak¹,

Cicekliyurt²

2022

ATJMED

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Aim: Hypertension is an emerging health problem related to cardiovascular disease, and many reports have shown the link between hypertension and obesity in different populations. In that study, we would like to evaluate the body fat accumulation type and obesity-related parameters with hypertension. Material and Methods: Hypertensive and normotensive individuals were enrolled in Bandırma Training and Research Hospital, Cardiology Units. The cardiologist examined the demographic data, obesity-related parameters, and current health status. Blood pressures were measured under the European Heart Society Recommendations. The data was accepted statistically within the 95% confidence interval (p<0.05). Results: The mean age of hypertensive and normotensive individuals was 60.25±12.45 vs. 57.78±11.17, p=0.05), respectively. A statistically significant increase was observed in BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) status in hypertensive patients compared to controls. In contrast, hip circumference (HC) measurement is only higher only in hypertensive women than in normotensive (110.61±18.23 vs. 100.69±20.46; p:0.005), and there is no difference among men (108.56±16.16 vs107.93±16.78 p:0.82). Conclusion: Abdominal weight gain is an important issue for cardiovascular disease; thus, waist circumference (WC) is essential to evaluate the hypertension risk more than obesity status. Hypertensive women are more prone to have apple-type body shapes than hypertensive men were pear body shapes. In conclusion, body fat accumulation is a more crucial triggering factor for hypertension than body fat. Keywords: Hypertension, body fat, waist circumference, waist-to-hip ratio, Waist to height ratio

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Section: Discussionsupporting

confidence: 76%

The relation between obesity and hypertension

Colak¹,

Cicekliyurt²

2022

ATJMED

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“…Tee et al 27 reported that WHtR had the greatest ROC values [AUC = 0.78 and 0.82] in predicting high blood pressure among Malaysian adolescent boys and girls. Shrestha et al 28 reported that WHtR had the highest ROC value [AUC = 0.60] as the best screening tool for hypertension among the Nepali population. Bacopoulou et al 21 reported that WHtR had the utmost ROC value [AUC = 0.97] in predicting abdominal obesity among Greek adolescents.…”

Section: Discussionmentioning

confidence: 99%

Comparison of adiposity anthropometric indices and their associations with visceral fat levels determined by bioelectrical impedance analysis among diabetic patients

Tuglo

2022

Sci Rep

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Visceral fat (VF) and its effect on metabolic disorders have been extensively studied; nevertheless, there is a need for a simple and reliable index to equally assess VF in low-resource settings. This multihospital-based study was designed to compare the five adiposity anthropometric indices and their associations with VF levels determined by bioelectrical impedance analysis as the reference standard among diabetic patients. A pretested questionnaire was used to collect anthropometric, biochemical and hemodynamic data from 473 diabetic patients. Regression analysis was performed to determine the associations between the five adiposity anthropometric indices and VF levels. Receiver operating characteristic (ROC) curves were used to confirm the predictive capacities of the five adiposity anthropometric indices with VF levels. The waist-to-height ratio WHtR showed the greatest ROC value [area under the curve (AUC) = 0.745, p ˂0.001] in identifying diabetic patients with high VF levels compared to body mass index BMI [AUC = 0.584, p = 0.047], waist circumference WC [AUC = 0.723, p ˂0.001], hip circumference HC [AUC = 0.647, p ˂0.001] and waist-to-hip ratio WHR [AUC = 0.711, p ˂0.001]. Likewise, the regression analysis of WHtR and VF levels revealed the strongest association [unadjusted odds ratio (UOR) = 21.49, p < 0.001] compared to BMI [UOR = 6.77, p = 0.008], WC [UOR = 6.37, p < 0.001], HC [UOR = 5.93, p = 0.002] and WHR [UOR = 13.17, p < 0.001]. The optimal cut-off values to identify diabetic patients with high VF levels were > 0.5 for WHtR, > 25.7 kg/m2 for BMI, > 80.5 cm for WC, > 95.5 cm for HC and > 0.82 for WHR. WHtR was shown to have overpowered BMI, HC, WC and WHR in identifying diabetic patients with high VF levels. Therefore, the Ghana Health Service could recommend WHtR as a better diagnostic index for assessing VF levels due to its high predictive capacity.

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“…CHEERS was selected purposively as this tertiary centre has regularly been conducting different non-communicable diseases screening programs for free at its health promotion unit since 2016. 9 , 10…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus among Adult Outpatients Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study

Khatri¹,

Kayastha²,

Shrestha³

et al. 2022

J Nepal Med Assoc

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Introduction: Diabetes mellitus is a chronic metabolic disease characterised by elevated blood sugar levels and is a pandemic of public health importance. Screening programs can help reduce morbidity and mortality by preventing or delaying complications. This study aimed to find out the prevalence of diabetes mellitus among adult outpatients visiting a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among outpatients visiting a tertiary care centre between 1 January 2019 to 31 December 2019. Ethical approval was obtained from the Ethical Review Board (Registration number: 408/2020 P). Patients with unknown history of diabetes participating in free random blood sugar examinations were included in the study. Systematic random sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 385 adult outpatients, 17 (4.42%) (2.37–6.47, 95% Confidence Interval) had diabetes. The mean random blood sugar level of the diabetic patients was 281.41±57.49 mg/dl. Conclusions: The prevalence of diabetes mellitus among adult outpatients was similar to previous studies conducted in similar settings. Random blood sugar test in hospital outpatient settings is feasible to identify people with diabetes mellitus.

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BMI, waist to height ratio and waist circumference as a screening tool for hypertension in hospital outpatients: a cross-sectional, non-inferiority study

Cited by 20 publications

References 33 publications

The relation between obesity and hypertension

The relation between obesity and hypertension

Comparison of adiposity anthropometric indices and their associations with visceral fat levels determined by bioelectrical impedance analysis among diabetic patients

Diabetes Mellitus among Adult Outpatients Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study

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