Department of Social Medicine and Health Managemant of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan.
Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan.
J Hypertens. 2018 Dec;36(12):2406-2413. doi: 10.1097/HJH.0000000000001852.
The American Heart Association concluded that waist circumference was a better predictor of blood pressure risk than BMI in Asians. However, data are inconsistent and information in Chinese, the largest global population group, is limited.
Data was obtained from the Chinese National Stroke Prevention Project Survey of a nationally representative sample of middle-aged and older Chinese adults. A total of 135 825 individuals not taking any antihypertensive drugs were included in this study. Multiple linear regression analyses were conducted to examine the association between blood pressure and parameters of general adiposity, including BMI, height-adjusted weight, and parameters of central adiposity, including waist circumference, hip circumference, waist-hip ratio, and waist-height ratio. Results were shown as mean difference in blood pressure associated with one standard deviation higher level of adiposity.
The overall means ± standard deviation of BMI and waist circumference were 24.3 ± 3.18 kg/m and 84.0 ± 8.88 cm, respectively. BMI seemed more strongly associated with SBP/DBP (4.22 mmHg/SD; 2.60 mmHg/SD) than central adiposity markers. In addition, there were sex differences. For men, waist circumference showed a stronger association with SBP/DBP than BMI (4.04 vs. 3.79, P < 0.05; 2.26 vs. 2.13, P < 0.05). For women, BMI was more closely related to SBP/DBP than central adiposity parameters, such as waist circumference (4.59 vs. 3.41, P < 0.05; 2.98 vs. 2.24, P < 0.05). Additionally, in both urban and rural areas, waist circumference was mostly associated with SBP/DBP among men, whereas it was BMI among women.
Compared with central adiposity, blood pressure is more strongly associated with general adiposity in Chinese adults. Interestingly, there are significant sex differences in the relationship of blood pressure with general and central adiposity. Waist circumference is the strongest predictor for men but suboptimal for women, and BMI tend to a better predictor of blood pressure for women. In addition, our results for men are consistent with the recommendation of the American Heart Association in 2015 that waist circumference could be used for assessing the risk of blood pressure.
美国心脏协会得出结论，腰围是预测亚洲人血压风险的更好指标，优于 BMI。然而，数据不一致，且中文（全球最大的人群群体）的信息有限。
数据来自中国国家卒中预防项目调查，该调查是一项针对中国中年和老年人的全国代表性样本。本研究共纳入 135825 名未服用任何降压药物的个体。采用多元线性回归分析，研究血压与一般肥胖参数（包括 BMI、身高校正体重）以及中心性肥胖参数（腰围、臀围、腰臀比、腰围身高比）之间的关系。结果以血压每升高一个标准差与肥胖参数的差异表示。
BMI 和腰围的总体平均值±标准差分别为 24.3±3.18kg/m 和 84.0±8.88cm。与中心性肥胖指标相比，BMI 与 SBP/DBP 的相关性更强（4.22mmHg/SD；2.60mmHg/SD）。此外，还存在性别差异。对于男性，腰围与 SBP/DBP 的相关性强于 BMI（4.04 比 3.79，P<0.05；2.26 比 2.13，P<0.05）。对于女性，BMI 与 SBP/DBP 的相关性强于中心性肥胖参数，如腰围（4.59 比 3.41，P<0.05；2.98 比 2.24，P<0.05）。此外，在城乡地区，男性腰围与 SBP/DBP 的相关性最强，而女性则与 BMI 相关性最强。
与中心性肥胖相比，中国成年人的血压与一般肥胖的相关性更强。有趣的是，血压与一般和中心性肥胖的关系存在显著的性别差异。对于男性，腰围是最强的预测指标，但对于女性则不是；而 BMI 倾向于成为女性血压的更好预测指标。此外，我们对男性的研究结果与 2015 年美国心脏协会的建议一致，即腰围可用于评估血压风险。
