Association of anthropometric indices with elevated blood pressure in British adults

OBJECTIVE: To investigate which of six anthropometric indices was most strongly associated with elevated blood pressure and frank hypertension in a representative population sample of young and middle-aged British adults. SUBJECTS: A representative random sample of British adults (2712 men and 3279 women) aged between 18 and 64 y, who were resident in England, Scotland and Wales, were studied in the 1984–85 Health and Lifestyle Survey. MEASUREMENTS: Following an interview where demographic, health and lifestyle details were recorded, measurements of height, weight and waist and hip circumference were made by a nurse at a home visit, where blood pressure and medication to control blood pressure were also recorded. BMI and the ratios of waist circumference to height (WHTR) and waist circumference to hip (WHR) were calculated. Respondents with a blood pressure above 140 mm Hg (systolic) and/or 90 mm Hg (diastolic) or who were being treated for hypertension were classified as having elevated blood pressure. RESULTS: For men and women aged 18–39 and 40–64 y the prevalence of elevated blood pressure increased across the quintiles of BMI, weight, waist, WHTR and WHR was P<0.001 for each, with waist and WHTR having the highest odds ratios. Waist and height adjusted for each other were independently related to the prevalence of elevated blood pressure in 40–64 y old men and women. Height, on its own, was inversely related (P<0.05) only in the 40–64 y old men. The age adjusted partial correlations between systolic and diastolic blood pressure measurements and the measurements of BMI, weight, waist, WHTR and WHR were close and significant, P<0.001 for each. The ranking and significance of the correlations were hardly affected by excluding the treated hypertensives. CONCLUSIONS: The prevalence of elevated blood pressure was associated with quintiles of BMI, waist, WHTR, WHR and weight, with WHTR and WHR having the highest odds ratios. Waist and height were independently related to the prevalence of elevated blood pressure.