The Department of Endocrinology, 
Combining general and central measures of adiposity to identify risk of hypertension: a cross-sectional survey in rural India.
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia.
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia
- Pre-clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia.
- School of Population Health, UNSW, Sydney, Australia.
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
- Central University of Kerala, Kasaragod, India.
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney and Department of Cardiology, Westmead Hospital, Sydney, Australia.
- Melbourne School of Population and Global Health, University of Melbourne, Australia.
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Australia.
- Rishi Valley Rural Health Centre, Chittoor District, Andhra Pradesh, India.
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu, India.
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Trivandrum, Kerala, India.
- George Institute for Global Health, New Delhi, India
- University of New South Wales, Sydney, Australia.
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia. Electronic address: Amanda.thrift@monash.edu.
Obesity research & clinical practice Vol. 17 · Issue 3 · pp. 249-256
PMID 37142499 DOI 10.1016/j.orcp.2023.04.005
Cite This Article
Rathina Srinivasa Ragavan, Jordan Ismail, Roger G Evans, Velandai K Srikanth, Matthew Kaye, Rohina Joshi, Kavumpurathu R Thankappan, Clara K Chow, Michaela A Riddell, Brian Oldenburg, Ajay Mahal, Kartik Kalyanram, Kamakshi Kartik, Oduru Suresh, Nihal Thomas, Gomathyamma K Mini, Pallab K Maulik, Simin Arabshahi, Amanda G Thrift. Combining general and central measures of adiposity to identify risk of hypertension: a cross-sectional survey in rural India. Obesity research & clinical practice. 2023;17(3):249-256. doi:10.1016/j.orcp.2023.04.005
Abstract
AIM: In three socioeconomically diverse regions of rural India, we determined the optimal cut-offs for definition of overweight, the prevalence of overweight, and the relationships between measures of overweight and risk of hypertension.
SUBJECTS AND METHODS: Villages were randomly sampled within rural Trivandrum, West Godavari, and Rishi Valley. Sampling of individuals was stratified by age group and sex. Cut-offs for measures of adiposity were compared using area under the receiver operating characteristic curve. Associations between hypertension and definitions of overweight were assessed by logistic regression.
RESULTS: Of 11 657 participants (50 % male; median age 45 years), 29.8 % had hypertension. Large proportions were overweight as defined by body mass index (BMI) ≥ 23 kg/m (47.7 %), waist circumference (WC) ≥ 90 cm for men or ≥ 80 cm for women (39.6 %), waist-hip ratio (WHR) ≥ 0.9 for men or ≥ 0.8 for women (65.6 %), waist-height ratio (WHtR) ≥ 0.5 (62.5 %), or by BMI plus either WHR, WC or WHtR (45.0 %). All definitions of overweight were associated with hypertension, with optimal cut-offs being at, or close to, the World Health Organization (WHO) Asia-Pacific standards. Having overweight according to both BMI and a measure of central adiposity was associated with approximately twice the risk of hypertension than overweight defined by only one measure.
CONCLUSIONS: Overweight, as assessed by both general and central measures, is prevalent in rural southern India. WHO standard cut-offs are appropriate in this setting for assessing risk of hypertension. However, combining BMI with a measure of central adiposity identifies risk of hypertension better than any single measure. The risk of hypertension is significantly greater in those centrally and generally overweight than those overweight by a single measure.
Keywords
- Body mass index
- Hypertension
- India
- Prevalence
- Waist-hip ratio
