Body mass index and blood pressure: where are we now?

Abstract

The high prevalence rates of non-communicable diseases (NCDs) -particularly hypertension -in developing countries is gaining much attention. High disease burden in those environs has been consistent with the global projections of burden of disease from 1990 to 2020. 1 However, there is limited published information on NCD prevalence rates and related risk factors using the WHO STEPwise approach in developing countries.In the current issue of the Journal of Human Hypertension, Tesfaye et al. 2 report findings from surveys conducted in three countries in geoecologically diverse socio-demographic settings. Blood pressures and hypertension prevalence rates were much higher in men than in women, consistent with previous results demonstrating gender dichotomy in blood pressure, with higher pressures seen in men. The prevalence rates of the other NCD risk factors, such as tobacco use and alcohol consumption, were also much higher in men than in women.Of interest, a significant correlation was demonstrated between body mass index (BMI) and blood pressures in all the three populations, suggesting that BMI contributed to the reported hypertension prevalence rates. BMI was classified into underweight (o18.5 kg/m 2 ), normal BMI (18.5XBMIo 25 kg/m 2 ) and overweight or obese (BMIX25 kg/m 2 ) people. The strongest correlation was observed in Indonesia men and women, whereas the weakest correlation was reported among the Ethiopian women followed by the Ethiopian men. Distribution of mean systolic blood pressures across the full range of BMI quintiles in the three populations reveals that blood pressures begin to rise at lower BMI quintiles in high BMI populations compared with lean populations. Further, it was in the high BMI populations that high blood pressures were reported in the low BMI ranges. Based on the presence of high blood pressures in both underweight and overweight population subsets and the relatively low blood pressures in the normal range BMI range, the authors concluded that the blood pressure to BMI relationship was U or J shaped.Previous reports have described diverse hypertension prevalence rates and blood pressure distribution patterns in different settings but the blood pressure relationship with indices of obesity has largely been consistent including in urbanizationrelated hypertension and in populations in lifestyle transition. 3 Some conflicting results have been reported on the epidemiology of hypertension with the majority reporting increased hypertension rates in urban compared with rural settings, a phenomenon termed 'urbanization-related hypertension', 4 whereas a few have reported a decrease or no change in rates. 5 Although the majority of the population samples came from the rural environment in the three populations (100% from Vietnam, 90.3% in Indonesia and 70.3% in Ethiopia), the hypertension prevalence rates were higher in the urban areas where samples were studied. Indeed, urbanizationrelated hypertension has largely been attributed to increased psycho-social stress and to the contribut...

Diet and hypertension: a comparative analysis of four diet groups in South-Western Nigeria

“…The percentage of those that are hypertensive among the men is slightly higher than in women. This result is consistent with past literature [20,21]. Table 3 shows that the BMI for the majority of the respondents was less than 30 kg/m 2 .…”

Genetic and Environmental Dissections of Sub-Phenotypes of Metabolic Syndrome in the Chinese Population: A Twin-Based Heritability Study

“…The ob-genetic correlation between BMI and both systolic and diastolic blood pressures in Chinese which is consistent with the results obtained by Choh et al [27] in American Samoan families. Significant phenotype correlation between BMI and blood pressure has been reported by multiple studies across populations [28]. The detection of significant genetic contribution to the phenotype correlation between BMI and blood pressure suggests the existence of pleiotropic genetic mechanisms behind the two phenotypes and across populations.…”

Frequency of hypertension and the correlation between body mass index and level of hypertension among patients in different categories of obesity

“…Друге студије налазе да је однос артеријског при-тиска и гојазности значајан али низак, док неке не налазе позитивну корелацију крвног притиска и BMI и предлажу минимални праг за вредност BMI на коме почиње повеза-ност BMI са крвним притиском 22,27 . Једно од потенцијалних објашњења за ниску коре-лацију је постојање унутрашње индивидуалне варијабил-ности у дистрибуцији телесне масти, код људи, која може јаче или слабије повезивати телесну тежину и крвни при-тисак у зависности од тога где се масно ткиво налази 28 .…”

“…Такође, на неконзистентност резултата корелације BMI и крвног притиска могу да утичу и сазнања добијена новијим истраживањима која су показала да у популацији гојазних, са BMI >30 kg/m², крвни притисак најпре почиње да расте у особа са нижим вредностима BMI па тек касније код оних са већим вредностима BMI 27 . Ово потврђују и наши налази јер су гојазне особе са нижим BMI >30 kg/m², a <40 kg/m², имале веће просе-чне вредности систолног притиска од особа сa BMI >40 kg/m².…”

“…На основу присуства високог крвног притиска у популацији неухрањених и гојазних особа, и релативно ниског притиска у популацији нормално ухрањених, неке студије су показале да је крвни притисак у односу нa BMI био у облику слова U или J 27 . Могуће објашњење постојања корелације BMI и крвног притиска код наших нормално ухрањених испи-таника, са BMI <25 kg/m², може указивати да међу њима постоје метаболички гојазне особе са могућим увећањем масне и интраабдоминалне масне масе и повећаним вред-ностима крвног притиска 32 .…”