Body Fat Distribution and Systolic Blood Pressure in 10,000 Adults with Whole‐Body Imaging: UK Biobank and Oxford BioBank

Abstract

Objective This study aimed to quantify the associations of regional fat mass and fat‐free mass with systolic blood pressure. Methods This analysis combined individual participant data from two large‐scale imaging studies: UK Biobank and Oxford BioBank. In both studies, participants were interviewed and measured, and they underwent dual‐energy x‐ray absorptiometry imaging. Linear regression was used to relate systolic blood pressure to anthropometric measures of adiposity (BMI, waist circumference, and waist to hip ratio) and dual‐energy x‐ray absorptiometry–derived measures of body composition (visceral android fat, subcutaneous android fat, subcutaneous gynoid fat, and fat‐free mass). Results Among 10,260 participants (mean age 49; 96% white), systolic blood pressure was positively associated with visceral android fat (3.2 mmHg/SD in men; 2.8 mmHg/SD in women) and fat‐free mass (1.92 mmHg/SD in men; 1.64 mmHg/SD in women), but there was no evidence of an association with subcutaneous android or gynoid fat. Associations of systolic blood pressure with BMI were slightly steeper than those with waist circumference or waist to hip ratio; these associations remained unchanged following adjustment for fat‐free mass, but adjustment for visceral android fat eliminated associations with waist circumference and waist to hip ratio and more than halved associations with BMI. Conclusions This analysis indicates that visceral fat is the primary etiological component of excess adiposity underlying the development of adiposity‐related hypertension.

Gender-specific associations of anthropometric measures of adiposity with blood pressure and hypertension in young Chinese Medical College Students

“…Previous studies have indicated that compared with Europeans, Asians seem to have more abdominal adiposity [16]. Moreover, independent of gender, higher abdominal adiposity, especially abdominal visceral fat, was associated with various metabolic risks, including insulin resistance [23], arterial stiffness [24], higher blood pressure [18] and odds of hypertension. Thus, as showed in our slim medical college students, adiposity indices that capture central fat distribution might be more informative for blood pressure status in young Chinese.…”

“…BMI is steadily associated with an increased risk of hypertension and type 2 diabetes, although this measure does not account for variation in body fat distribution and abdominal fat mass, which can differ signi icantly across populations and can vary substantially within a narrow range of BMI [16]. Some studies also explored measures accounting for body fat distribution and abdominal fat in different populations [12,17,18]. However, the predictive values of those anthropometric measures were signi icantly different in men and women, in different ethnicities or age groups [6,11,19,20].…”

Prognostic value of adiposity indices for hypertension

“…It has been investigated about the different mechanisms that could explain the relationship between obesity and hypertension, such as the adipocyte dysfunction, insulin resistance, the sympathetic nervous system and the renin‐angiotensin system dysfunction, or the increased intravascular volume and elevated cardiac output . It has even been suggested that visceral fat is in the origin of excess adiposity underlying the development of adiposity‐related hypertension, according to observational community studies . Lee et al suggested that both quantity and quality of the adipose tissue constitutes a major contributor for the development or prevention of cardiovascular risk factor profiles …”

“…4 It has even been suggested that visceral fat is in the origin of excess adiposity underlying the development of adiposity-related hypertension, according to observational community studies. 5 Lee et al suggested that both quantity and quality of the adipose tissue constitutes a major contributor for the development or prevention of cardiovascular risk factor profiles. 6 Several studies have explored the relationship of hypertension with obesity in a cross-sectional way.…”

“…Park et al 3 used a tetrapolar bioelectrical impedance analysis. Although most investigators report bioelectrical impedance analyses to estimate BF%, 5,17,19,20,23 other authors determined BF% by means of other methods such as a chemical four-compartment model 16 or the skinfold thickness measurement. 11 The study by Park et al 3 validates previously reported information on the importance of measuring BF% even in non-obese individuals to detect those who have an increased risk of developing hypertension, in a Korean population.…”