Esmaeili Fataneh, Karimi Keyvan, Akbarpour Samaneh, Naderian Mohammadreza, Djalalinia Shirin, Tabatabaei-Malazy Ozra, Golestani Ali, Rezaei Nazila
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2025 Jan 20;25(1):241. doi: 10.1186/s12889-024-21264-4.
The coexistence of obesity and hypertension (HTN) is a global health concern due to its association with various health abnormalities. This study targeted the association between uncontrolled HTN-defined according to the JNC8 guidelines- and different obesity patterns (general and abdominal) among adult hypertensive individuals.
Data for the present investigation were obtained from the 2021 STEPwise Approach to NCD Risk Factor Surveillance (STEPS) national survey in Iran. Participants were classified based on general obesity (BMI) and different abdominal obesity patterns (waist circumference [WC], waist-to-hip ratio [WHR], and waist-to-height ratio [WHtR]). Data were weighted by sex, age, and residence (rural and urban). Multivariate logistic regression models were performed to determine the association between different obesity patterns and uncontrolled HTN, adjusting for confounders including demographic variables, lifestyle factors, and history of metabolic abnormalities.
A total of 8,692 hypertensive adult subjects ≥ 18 years were recruited from all provinces in Iran. The overall mean age of participants was 55.8 ± 0.15, and 55.6% being women. The prevalence of general obesity among controlled and uncontrolled hypertensive patients was 30.3% and 69.8%, respectively. Regarding abdominal obesity, the prevalence among controlled and uncontrolled hypertensive patients was 29.8% and 70.2% based on WC, 28.4% and 71.6% based on WHR, and 28.8% and 71.2% based on WHtR, respectively. Compared to normal weight, underweight (adjusted odds ratio [AOR] = 0.94, 95% CI: 0.57-1.56), overweight (1.37 [1.16-1.61]), and general obesity (1.47 [1.24-1.75]) were associated to uncontrolled HTN compared to normal weight. Abdominal obesity according to WC (1.30 [1.13-1.51]), WHR (1.31 [1.10-1.53]), and WHtR (1.39 [1.11-1.74]) was also associated with uncontrolled HTN.
Both general and abdominal obesity are more prevalent and strongly associated with uncontrolled HTN in hypertensive patients. These findings underscore the need for healthcare providers to implement targeted interventions promoting healthy lifestyle changes to mitigate these risk factors and improve HTN management.
肥胖与高血压（HTN）并存是一个全球性的健康问题，因为它与各种健康异常情况相关联。本研究旨在探讨根据美国国家综合癌症网络（JNC8）指南定义的未控制的高血压与成年高血压患者中不同肥胖模式（全身性肥胖和腹型肥胖）之间的关联。
本研究的数据来自2021年伊朗全国非传染性疾病风险因素监测（STEPS）调查。参与者根据全身性肥胖（体重指数[BMI]）和不同的腹型肥胖模式（腰围[WC]、腰臀比[WHR]和腰高比[WHtR]）进行分类。数据按性别、年龄和居住地（农村和城市）进行加权。采用多变量逻辑回归模型来确定不同肥胖模式与未控制的高血压之间的关联，并对包括人口统计学变量、生活方式因素和代谢异常病史等混杂因素进行了调整。
从伊朗所有省份招募了总共8692名年龄≥18岁的高血压成年受试者。参与者的总体平均年龄为55.8±0.15岁，女性占55.6%。在血压得到控制和未得到控制的高血压患者中，全身性肥胖的患病率分别为30.3%和69.8%。关于腹型肥胖，根据腰围，血压得到控制和未得到控制的高血压患者中的患病率分别为29.8%和70.2%；根据腰臀比，分别为28.4%和71.6%；根据腰高比，分别为28.8%和71.2%。与正常体重相比，体重过轻（调整后的优势比[AOR]=0.94，95%置信区间：0.57-1.56）、超重（1.37[1.16-1.61]）和全身性肥胖（1.47[1.24-1.75]）与未控制的高血压相关。根据腰围（1.30[1.13-1.51]）、腰臀比（1.31[1.10-1.53]）和腰高比（1.39[1.11-1.74]）定义的腹型肥胖也与未控制的高血压相关。
全身性肥胖和腹型肥胖在高血压患者中更为普遍，并且与未控制的高血压密切相关。这些发现强调了医疗保健提供者需要实施有针对性的干预措施，促进健康的生活方式改变，以减轻这些风险因素并改善高血压管理。
