|Year : 2018 | Volume
| Issue : 1 | Page : 46-48
Correlation of abdominal obesity indices with blood pressure in young adults: A cross-sectional study
Sunil Kumar Jena
Department of Physiology, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Odisha, India
|Date of Web Publication||5-Jan-2018|
Dr. Sunil Kumar Jena
Department of Physiology, Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Odisha
Source of Support: None, Conflict of Interest: None
Background: The youth of this era are the sufferings of overweight and obesity because of sedentary lifestyle, eating habits, altered pattern of behaviour and mental stress. Abdominal obesity is a predominant risk factor of cardiovascular disease. With this background, this study was proposed to correlate abdominal obesity with blood pressure (BP) in young adults. Materials and Methods: A total of 205 young male adults of 20–25 years were selected from various local educational institutions. Estimation for waist circumference (WC), hip circumference (HC) and BP recording was done. Waist–hip ratio (WHR) was calculated from WC and HC. Recording of BP was performed between 8 and 9 am after 5–10 min rest. On the basis of WC, participants were classified into two groups, i.e., WC ≤90 cm and WC >90 cm. On the basis of WHR, participants were classified into two groups, i.e., WHR <0.90 and WHR ≥0.90. Results: In the present study, we found that the participants those WC and WHR above the cut-off value shown significantly more BP (both systolic and diastolic) than normal. Likely, the pulse pressure was higher in participants WC and WHR above cut-off value but not significant. We found a positive correlation between WC and WHR with BP. Conclusion: This study suggested that WC and WHR have a positive correlation with BP and hence concluded that adults with abdominal obesity are at higher risk to develop CVD in their future life.
Keywords: Abdominal obesity, cardiovascular disease, waist circumference, waist-hip ratio, young adults
|How to cite this article:|
Jena SK. Correlation of abdominal obesity indices with blood pressure in young adults: A cross-sectional study. Adv Hum Biol 2018;8:46-8
| Introduction|| |
Overweight and obesity are the epidemic for young adults in developing country like India due to sedentary lifestyle, eating habits and inadequate physical activity. Obesity has been found to increase the risk of morbidities and mortalities, including cardiovascular disease (CVD), diabetes, gallbladder disease, respiratory disease, cancer, arthritis and gout.,, Central distribution of body fat suggests excessive deposition of intra-abdominal fat in other words known as abdominal obesity found to be one of the important predictors of CVD risk., Researchers in one study after careful review suggested that the markers of general obesity (e.g., body mass index [BMI]) and the markers of abdominal adiposity (e.g., waist circumference [WC], Waist–hip ratio [WHR]) are strongly the events of CVD. It has also been suggested that markers of abdominal obesity are better predictors of CVD than the markers of general obesity. More superficial body fat or subcutaneous fat contributes to high WC and WC cannot provide information about visceral fat and hence abdominal obesity. The WHR is a simple ratio is a very important parameter can eliminate the limitation of WC and reliable indicator of abdominal obesity. Still, WC and WHR are considered as reliable predictors of CVD risk. Several epidemiological studies from different populations have reported a significant association between different anthropometric indicators and blood pressure (BP) levels., Several studies have been carried out about the effect of obesity on various CVD events. Most of the studies conducted in western countries, very less were in Asian countries and few among young adults. Considering the above facts, this study was proposed to find the correlation of abdominal obesity indices WC and WHR with BP in young adults.
| Materials and Methods|| |
This study was conducted in Department of Physiology of an educational health institution in eastern India. This cross-sectional study was completed between January and December 2016 after getting approval by the Institutional Ethical Committee and Institutional Review Board of the institution. This study was hypothesized to correlate between abdominal obesity indices (WC and WHR) with BP. A total of 205 young male adults, age between 20 and 25 years apparently healthy were selected from various local educational institutions. Face-to-face interview and general examination were conducted to select the participants. Collection of data regarding the name, age, history of any systemic disease, current medication, smoking and alcohol history was done by face-to-face interview. Both face-to-face interview and general examination were done by the researchers. Participants selected for this study were all apparently healthy young adults. Those were suffering from any CVD, respiratory disease, endocrine disease, renal disease, neural disease, hypertension, family history of diabetes mellitus, smokers, alcoholics and on current medication were excluded from the study. After selection of participants, they were explained properly about the purpose of the study. An informed written consent was obtained from each participant. All participants underwent estimation for WC, hip circumference (HC) and BP recording. WC and HC were measured by a standard measuring tape. WC was measured as per the recommendation of the WHO STEPS for surveillance (2008) protocol at the approximate midpoint between the lower margin of last palpable rib and the top of the iliac crest by a measuring tape. HC was measured around the widest portion of the buttocks, with the measuring tape parallel to the floor. For measurement of waist and HC, the participants were instructed to stand with close feet, arms at the side and body weight evenly distributed across the feet, and with light clothing. WC and HC measurement were nearest to 0.5 cm. WHR was calculated by formula waist WC divided by HC (WHR = WC/HC).
Recording of BP was performed between 8 and 9 am after 5–10 min rest. BP was recorded by auscultatory method using Elcometer sphygmomanometer. Recording of BP was done in the right arm sitting position. BP recording included systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP). PP was calculated by the formula: PP = SBP-DBP.
On the basis of WC participants were classified into two groups, i.e., WC ≤90 cm and WC >90 cm (International Diabetes Federation cut-off points for South Asians). On the basis of WHR, participants were classified into two groups, i.e., WHR <0.90 and WHR ≥0.90 (WHO cut-off points).
Analysis of data was performed by statistical software SPSS (Statistical Package for the Social Sciences, IBM Corporation, Armonk, New York, USA) version 16. Statistical analysis was performed by unpaired t-test and Pearson correlation. P < 0.05 was considered to be statistically significant. Generation of tables and graphs was done by Microsoft word and excel.
| Results|| |
In this study, our focus was to establish the correlation between abdominal obesity indices and BP in the healthy young adult male.
[Table 1] depicts the effect of WC on BP. Among the 205 participants, 36 participants WC was above the cut-off point 90 cm. The SBP of participants WC >90 was 129 ± 21.9 mmHg and WC ≤90 was 119 ± 8.7 mmHg (P = 0.012). The DBP of participants WC >90 was 86 ± 7.6 mmHg and WC ≤90 was 79 ± 6.9 mmHg (P = 0.000). The PP of participants WC >90 was 42 ± 16.8 mmHg and WC ≤90 was 39 ± 8.6 mmHg (P = 0.325).
[Table 2] depicts the effect of WHR on BP. The SBP of participants WHR ≥0.9 was 128 ± 18.6 mmHg and WHR <0.9 was 118 ± 8.8 mmHg (P = 0.001). The DBP of participants WHR ≥0.9 was 89 ± 6.7 mmHg and WHR <0.9 was 78 ± 6.4 mmHg (P = 0.000). The PP of participants WHR ≥0.9 was 41 ± 14.5 mmHg and WHR <0.9 was 40 ± 9.0 mmHg (P = 0.654).
[Table 3] depicts the correlation between abdominal obesity indices and BP. There was positive correlation between WC and SBP (r = 0.473), WC and DBP (r = 0.523), WC and PP (r = 0.567). There was positive correlation between WHR and SBP (r = 0.195), WHR and DBP (r = 0.267), WHR and PP (r = 0.266).
|Table 3: Correlation between waist circumference and waist–hip ratio with blood pressure|
Click here to view
| Discussion|| |
In broad sense generalized as well as abdominal obesity are relevant factors of morbidity and mortality incidence. CVD is one of the leading causes of obesity-related deaths, and abdominal obesity is the principal predisposing factor. BMI is the standard parameter to measure body size and body composition as well as it establishes various nutritional statuses such as underweight, overweight and obese. Still, some alternative parameters which measure abdominal adiposity are WC, WHR and waist–height ratio. These parameters are suggested to be superior to BMI in predicting CVD risk. This rationality is based on the fact: more visceral adipose tissue is associated with metabolic abnormalities, low glucose tolerance, decreased insulin sensitivity and lipid profile abnormalities which contributing factors of CVD.
In the present study, we found that the participants those WC and WHR was above the cut-off point shown significantly more BP (both SBP and DBP) than normal. Likely, the PP was higher in participants WC and WHR above cut-off value but not significant. We found a positive correlation between WC and BP (SBP, DBP, PP) as well as WHR and BP (SBP, DBP, PP).
Importance of BMI, WC, and WHR has been recognized for estimating CVD risk factors, particularly due to their positive association with hypertension. Significant positive correlation between WHR and systolic and DBP have been reported earlier.,,, In their study, Woo et al. reported that waist–hip ratio was not a useful predictor of health outcome while a study by Dalton et al. found that BMI, WC and WHR were equally related with hypertension., After an exclusive review, Huxley et al. suggested that marker of general obesity (BMI) and markers of abdominal obesity are strongly correlated with CVD. After proper analysis the authors also put their view that WC and WHR are relatively better predictors of CVD risk than BMI although in combination BMI, WC and WHR may improve their discriminatory capability. For any given level of WC, WHR or BMI the person is more risk and more prone to develop diabetes mellitus and hypertension which ultimately are the leading cause of CVD. Recent work suggests that a high PP is an important risk factor for heart disease. A meta-analysis in 2000, which combined the results of several studies of 8000 elderly patients in all, found that a 10 mmHg increase in PP increased the risk of major cardiovascular complications and mortality by nearly 20%.
| Conclusion|| |
Various studies suggested abdominal obesity as a predominant risk factor of CVD. This study suggested that WC and WHR has positive correlation with BP and hence concludes that abdominal obesity may be considered as an important risk factor of CVD. Abdominal obesity indices such as WC and WHR are very simple and easy measures may be used for screening purpose and provides preliminary information of cardiovascular risk.
The author would like to thank the participants involved in this study without whom it could not come to an end and also thank to paramedical staffs of this department for their help towards this work.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Pi-Sunyer FX. Health implications of obesity. Am J Clin Nutr 1991;53:1595S-603S.
Kannel WB, D'Agostino RB, Cobb JL. Effect of weight on cardiovascular disease. Am J Clin Nutr 1996;63:419S-22S.
Seidell JC, Verschuren WM, van Leer EM, Kromhout D. Overweight, underweight, and mortality. A prospective study of 48,287 men and women. Arch Intern Med 1996;156:958-63.
Björntorp P. Metabolic implications of body fat distribution. Diabetes Care 1991;14:1132-43.
Larsson B, Svärdsudd K, Welin L, Wilhelmsen L, Björntorp P, Tibblin G, et al.
Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. Br Med J (Clin Res Ed) 1984;288:1401-4.
Huxley R, Mendis S, Zheleznyakov E, Reddy S, Chan J. Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk – A review of the literature. Eur J Clin Nutr 2010;64:16-22.
Gupta R, Mehrishi S. Waist-hip ratio and blood pressure correlation in an urban Indian population. J Indian Med Assoc 1997;95:412-5.
Adedoyin RA, Mbada CE, Bisiriyu LA, Adebayo RA, Balogun MO, Akintomide AO, et al.
Relationship of anthropometric indicators with blood pressure levels and the risk of hypertension in Nigerian adults. Int J Gen Med 2008;1:33-40.
Pi-Sunyer FX. Medical hazards of obesity. Ann Intern Med 1993;119:655-60.
Shahbazpour N. Prevalence of overweight and obesity and their relation to hypertension in adult male university students in Kerman, Iran. Int J Endocrinol Metab 2003;2:55-60.
Seidell JC, Cigolini M, Deslypere JP, Charzewska J, Ellsinger BM, Cruz A, et al.
Body fat distribution in relation to serum lipids and blood pressure in 38-year-old European men: The European fat distribution study. Atherosclerosis 1991;86:251-60.
Assmann G, editor. Lipid Metabolism Disorders and Coronary Heart Disease: Primary Prevention, Diagnosis, and Therapy Guidelines for General Practice. 2nd
ed. Munich: MMV Medizin Verlag; 1993. p. 281.
Bonora E, Zenere M, Branzi P, Bagnani M, Maggiulli L, Tosi F, et al.
Influence of body fat and its regional localization on risk factors for atherosclerosis in young men. Am J Epidemiol 1992;135:1271-8.
Woo J, Ho SC, Yu AL, Sham A. Is waist circumference a useful measure in predicting health outcomes in the elderly? Int J Obes Relat Metab Disord 2002;26:1349-55.
Dalton M, Cameron AJ, Zimmet PZ, Shaw JE, Jolley D, Dunstan DW, et al.
Waist circumference, waist-hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults. J Intern Med 2003;254:555-63.
Blacher J, Staessen JA, Girerd X, Gasowski J, Thijs L, Liu L, et al.
Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch Intern Med 2000;160:1085-9.
[Table 1], [Table 2], [Table 3]