Body fat distribution and hypertension incidence in women and men. The NHANES I Epidemiologic Follow-up Study.

OBJECTIVE

To test the hypothesis that an elevated ratio of subscapular to triceps skinfold thickness (SFR), one measure of truncal obesity, is associated with increased incidence of essential hypertension.

DESIGN

Data from the NHANES I Epidemiologic Follow-up Study (NHEFS) were analyzed.

SUBJECTS

A cohort of 4303 women and 2579 men with complete data who were normotensive at baseline in 1971-1975.

MEASUREMENTS

Incidence of hypertension, blood pressure 160/95 mm Hg or greater or on blood pressure medication at follow-up in 1982-1984.

RESULTS

There was a statistically significant increase in risk of hypertension over approximately 10 y follow-up in white women aged 25-74 y with SFR in the fifth compared to the first quintile independent of age and body mass index (BMI) (relative risk = 1.52, 95% confidence interval 1.13-2.06, P = 0.006). The association was somewhat diminished after controlling for baseline blood pressure, change in BMI and other risk variables. An even stronger association was seen for subscapular skinfold and hypertension incidence. In white men aged 25-74 y, a significant association of high SFR with age-, BMI-adjusted risk of hypertension was seen (RR = 1.41, 95% CI 1.01-1.96, P = 0.04). Data for black women or black men failed to reveal significant variation in hypertension risk among quintiles of SFR or subscapular skinfold except in black women with low baseline BMI.

CONCLUSIONS

Data from NHEFS confirm the association of higher truncal obesity with increased incidence of hypertension in white women. Further studies are needed, especially in larger samples of black women.