Regional fat localizations and racial/ethnic variations in odds of hypertension in at-risk American adults

Abstract

The objective of this study was to determine the contribution of regional fat localizations defined as abdominal (AO) or truncal (TO) obesity in racial/ethnic differences to the prevalence odds of hypertension in overweight American adults. Data (n ¼ 5694) from the 1999-2002 US National Health and Nutrition Examination Survey were utilized for this analysis. Abdominal obesity was defined as waist circumference X102 and X88 cm for men and women, respectively. Truncal obesity was defined using ratio of subscapular to triceps skinfold thickness and were X2.24 and X1.32, for men and women, respectively. Prevalence odds ratios from gender-specific logistic regression models were used to evaluate the contribution of regional fat localizations to racial/ethnic variation in hypertension. Statistical adjustment was made for age, education, alcohol intake and body mass index. In both men and women, coexistence of AO and TO was associated with much higher prevalence odds of hypertension than association due to each of the regional fat localizations. In men, coexistence of AO and TO was associated with 1.99, 2.47 and 2.10 increased prevalence odds of hypertension in Whites, Blacks and Mexican Americans, respectively. The corresponding values in women were 2.83, 4.07 and 3.61 in Whites, Blacks and Mexican Americans, respectively. The coexistence of AO and TO appears to be the culprit that contributes to high blood pressure on top of body mass index. Weight reduction programs that are targeted toward abdominal and truncal regions in at-risk populations and along racial/ethnic lines may help to alleviate racial/ethnic disparity in risk of hypertension.

Appropriateness of waist circumference and waist-to-hip ratio cutoffs for different ethnic groups

“…However, Haffner et al (1996) reported lower insulin sensitivity in African-Americans compared with that in whites even after accounting for differences in body fat distribution. African-American men and women also have an increased risk for hypertension at a given WC (Harris et al, 2000;Okosun et al, 2001Okosun et al, , 2006, and have higher ApoB/ApoA1 values associated with the WC cutoffs of 94 and 80 cm (Okosun et al, 1999c) than white men and women.…”

“…Ethnic waist circumference and waist-to-hip cutoffs SA Lear et al than non-Hispanic whites at a similar WC (Okosun et al, 2006). A total of five studies investigated Hispanic-specific WC cutoffs (Table 4) (Berber et al, 2001;Sanchez-Castillo et al, 2003;Zhu et al, 2005;Okosun et al, 2000a, c).…”

Mycophenolate mofetil prevents high-fat diet-induced hypertension and renal glomerular injury in Dahl SS rats

“…Previous reports suggest that patients with salt‐sensitive (SS) hypertension also have a greater blood pressure response to weight gain (Okosun et al. ; Kotchen et al. ).…”

“…Human studies have suggested a genetic component in the blood pressure responsiveness to increased dietary salt and weight gain (Grim et al 1980;Egan et al 1989;Weinberger 1996;Agapitov et al 2008). Previous reports suggest that patients with salt-sensitive (SS) hypertension also have a greater blood pressure response to weight gain (Okosun et al 2006;Kotchen et al 2008). The Centers for Disease Control and Prevention reported that hypertensive renal injury is not declining and is the ninth cause of death in the United States (Molony and Craig 2009).…”

Abdominal Fat and African-Americans: Incidence and Relationship to Disease

“…BMI was different among the three groups of men. Okosun et al [25] followed this by analyzing NHANES data from 1999-2002 only to discover similar results. Compared to Mexican-American and white women, black women had significantly higher BMI values, abdominal obesity (WC ≥ 88 cm in women and ≥102 cm in men), truncal obesity (estimated as the ratio of subscapular to triceps skinfold thickness), coexistence of abdominal and truncal obesity, and prevalence of hypertension.…”