Normal-Weight Abdominal Obesity: A Risk Factor for Hypertension and Cardiometabolic Dysregulation

J of Clinical Hypertension

Liu

et al. 2022

Self Cite

This study aims to investigate the association between waist circumference and the development of hypertension based on a nationwide cohort Chinese population. A total of 5330 individuals free of hypertension at baseline were collected from the China Health and Retirement Longitudinal Study. The association between waist circumference and the development of hypertension was analyzed by an adjusted cox regression model and visualized by restricted cubic splines. Further, we applied the supervised machine learning methods to evaluate the importance of multiple variates for newonset hypertension. Additionally, the robustness of the association was assessed by a subgroup analysis. A total of 1490 individuals (28.0%) developed hypertension during a mean follow-up of 3.32 years. The new-onset hypertension was more observed in those with increased waist circumference (P for trend < .001). In the fully adjusted Cox regression, each 10 cm increase of waist circumference would result in an 18% elevated risk of hypertension. The random forest method and the Extreme Gradient Boosting method revealed waist circumference as an important feature to predict the development of hypertension. The sensitivity analysis indicated a consistent trend between waist circumference and new-onset hypertension in all BMI categories. This study suggested high waist circumference as an independent risk factor for new-onset hypertension based on a nationwide cohort of Chinese adults aged ≥45 years old. Our results supported that waist circumference should be routinely measured.

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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High waist circumference is a risk factor of new‐onset hypertension: Evidence from the China Health and Retirement Longitudinal Study

J of Clinical Hypertension

Liu

et al. 2022

Self Cite

“…Therefore, BMI-defined obesity is insufficient to fully capture the obesity-related metabolic risk. Previous studies have demonstrated that waist circumference is closely associated with multiple cardiovascular diseases and all-cause mortality independent of BMI ( 27 , 41 ). When evaluating obesity-related metabolic risk, these data supported that waist circumference and BMI were irreplaceable adiposity indexes.…”

Section: Discussionmentioning

confidence: 99%

Trends in general and abdominal obesity in US adults: Evidence from the National Health and Nutrition Examination Survey (2001–2018)

Huang²,

Yang³

et al. 2022

Front. Public Health

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AimThis study investigates the trend in general obesity and abdominal obesity in US adults from 2001 to 2018.MethodsWe included 44,184 adults from the nine cycles of the continuous NHANES (2001–2002, 2003–2004, 2005–2006, 2007–2008, 2009–2010, 2011–2012, 2013–2014, 2015–2016, and 2017–2018). The age-adjusted mean body mass index and waist circumference were calculated, and the sex-specific annual change was estimated by the survey cycle. We used the weighted sex-specific logistic regression models to analyze the prevalence of general obesity and abdominal obesity from 2001 to 2018. The weighted adjusted odds ratio (OR) with a 95% confidence interval (CI) was calculated.ResultsOur study showed that general obesity and abdominal obesity account for about 35.48 and 53.13% of the US population. From 2001–2002 to 2017–2018, the age-adjusted prevalence of general obesity increased from 33.09 to 41.36% in females and from 26.88 to 42.43% in males. During 2001–2018, the age-adjusted prevalence of abdominal obesity increased from 57.58 to 67.33% in females and from 39.07 to 49.73% in males. A significant time-dependent increase was observed in the prevalence of general obesity (adjusted OR, 1.007; 95% CI 1.005–1.009, P < 0.001) and abdominal obesity (adjusted OR, 1.006; 95% CI, 1.004–1.008; P < 0.001).ConclusionGeneral obesity and abdominal obesity are a heavy health burden among US adults, and the increasing trend remains in both males and females from 2001 to 2018.

“…Moreover, a recent consensus statement has highlighted the importance of routine measurement of waist circumference alongside BMI in classifying obesity and identifying individuals with high obesity‐related risk 10 . Also, our previous studies have revealed that waist circumference is positively and significantly associated with hypertension prevalence and cardiometabolic dysregulation regardless of BMI 11,12 …”

Section: Discussionmentioning

confidence: 99%

High waist circumference is a risk factor for hypertension in normal‐weight or overweight individuals with normal metabolic profiles

Chen

J of Clinical Hypertension

Zhou

et al. 2022

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This study aims to investigate the relationship between waist circumference and hypertension risk in normal-weight/overweight individuals with normal cardiometabolic profiles. The authors included 7217 normal-weight and overweight individuals with normal cardiometabolic profiles from the 2001 to 2014 US National Health and Nutrition Examination Survey. The authors summarized demographic characteristics, cardiometabolic profiles, and behavioral factors across waist circumference quartiles. Then, in the logistic regression analysis, the authors observed a positive and significant association between waist circumference (as a continuous variable) and the prevalence of hypertension in all three models (nonadjusted, minimally adjusted, and fully adjusted), with odds ratios (95% confidence intervals) of 1.76(1.65-1.86), 1.29 (1.20-1.39), and 1.24 (1.09-1.40), respectively. When analyzed as a categorical variable, individuals in the highest waist circumference group had a 1.48fold increased risk of hypertension than the lowest group in the fully adjusted model. Moreover, the Cox regression analysis revealed a positive and significant association between waist circumference and all-cause mortality in individuals with hypertension in the nonadjusted model (HR, 1.27; 95% CI, 1.10-1.47) and the fully adjusted model (HR, 1.59; 95% CI, 1.22-2.06). In conclusions, our results showed that, even in those with normal metabolic profiles, high waist circumference was significantly associated with the increased prevalence of hypertension. And once hypertension has been established, patients with high waist circumference showed elevated all-cause mortality. Therefore, waist circumference should be routinely measured and controlled regardless of metabolic profiles.