Does body mass index or waist-hip ratio correlate with arterial stiffness based on brachial-ankle pulse wave velocity in Chinese rural adults with hypertension?

Abstract

Background The relationship between obesity indices and arterial stiffness (AS) has not been fully discovered nor has it been studied in depth in large hypertensive patient populations. The aim of this study was to explore the association between body mass index (BMI) and waist-hip ratio (WHR) levels and AS based on brachial-ankle pulse wave velocity (baPWV) in Chinese rural adults with hypertension. Methods This cross-sectional study analyzed 5049 Chinese rural adults with essential hypertension. BMI was calculated as the body weight in kilograms divided by the square of the height in meters (kg/m2). Central obesity was defined as WHR ≥ 0.9 for males and ≥ 0.85 for females. Measurement of arterial stiffness was carried out via brachial-ankle pulse wave velocity (baPWV). Results The prevalence of overweight, general obesity, central obesity and increased AS were 26.88%, 3.39%, 63.85% and 44.01%, respectively. Multivariate logistic regression analysis indicated that BMI levels were negatively associated with the prevalence of increased AS (adjusted-OR per SD increase: 0.74, 95% CI 0.67–0.81, P < 0.001). When BMI was instead treated as a categorical variable divided into tertiles, the same relationship was observed (P for trend < 0.001). Inversely, WHR levels were positively associated with the prevalence of increased AS (adjusted-OR per SD increase: 1.25, 95% CI 1.14–1.36, P < 0.001). Compared to subjects without central obesity, those with central obesity had a higher prevalence of increased AS (adjusted-OR: 1.52, 95% CI 1.28–1.81, P < 0.001). Linear regression models indicated similar results in the correlation between BMI or WHR levels and baPWV levels (adjusted-β per SD increase: − 0.57, 95% CI − 0.68 to − 0.46, P < 0.001; adjusted-β per SD increase: 4.46, 95% CI 3.04–5.88, P < 0.001). There were no interactions in terms of age and blood pressure on the relationship between BMI or WHR levels and the prevalence of increased AS or baPWV levels. Conclusion There was an inverse relationship between BMI levels and increased AS or baPWV levels, whereas WHR levels and central obesity were positively associated with increased AS or baPWV levels in Chinese rural adults with hypertension.

Association between weight-adjusted waist index and arterial stiffness in hypertensive patients: The China H-type hypertension registry study

“…Many clinical studies indicated that BMI is positively associated with increased PWV (12, 13). However, several studies suggested that BMI is negatively associated with high arterial stiffness (15,16). Moreover, Liao et al conducted a longitudinal study of 1553 subjects found that there was no relationship between the BMI and AS after correction for SBP and DBP (18).…”

“…Nevertheless, current researches are still controversial about the relationship between BMI and AS among different populations. In the past decade, some studies have found a positive association between BMI and AS (12-14), while others have found a negative association (15,16), and others have found no association (17,18). These discrepancies between the different studies may be attributed to different sample sizes, ethnic and regional variations.…”

Interaction Between Obesity and Hypertension on Arteriosclerosis in Chinese Urban Adults: A Population-Based Cross-Sectional Study

“…In this study, the results of the two-way ANOVA and the unconditional logistic regression models showed that hypertension was statistically significant in both baPWV and arteriosclerosis, which may suggest that hypertension is a crucial factor influencing arteriosclerosis. Approximately 23.2% of adults in China are estimated to suffer from hypertension, which is often accompanied by obesity (F. Hu et al, 2021).…”

“…arteriosclerosis, which may suggest that hypertension is a crucial factor influencing arteriosclerosis. Approximately 23.2% of adults in China are estimated to suffer from hypertension, which is often accompanied by obesity (F. Hu et al, 2021). We set the OR value of normal (BMI and blood pressure) participants to 1 as a reference in the unconditional logistic regression model to identify whether an interaction between obesity and hypertension affects the occurrence of arteriosclerosis.…”

Cut-off points for anthropometric indices to screen for hypertension among Iranian adults of the Bandare-Kong cohort: a cross-sectional study

“…Also, Esmaillzadeh et al concluded that WHR was a better screening measure for cardiovascular risk factors, especially HTN, than other anthropometric indices in adult men [ 20 ]. Evidence suggests that WHR is positively correlated with arterial stiffness [ 36 ], which plays a significant role in the pathogenesis of HTN and can predict the likelihood of cardiovascular events in hypertensive patients [ 37 ]. Moreover, excess abdominal fat deposition causes high-density lipoprotein (HDL) levels to decrease, and low-density lipoprotein (LDL) and triglyceride levels to increase, and a high LDL level is a well-established risk factor for HTN [ 38 ].…”