Body adiposity indices are associated with hypertension in a black, urban Free State community.

BACKGROUND

Non-communicable diseases, including hypertension, are increasing rapidly in resource-poor, developing countries amongst populations transitioning from traditional to westernised lifestyles; and are associated with excess weight.

AIM

To investigate the relationship between hypertension and various indices of body adiposity in a transitioning, urban, black population.

SETTING

Three hundred and thirty-nine adults (25-64 years) from a larger cross-sectional study (Assuring Health for All in the Free State) conducted in Mangaung, South Africa, were included.

METHODS

Standard techniques were used to determine blood pressure, HIV status, body mass index (BMI), waist-to-height ratio (WHtR) and body adiposity index (BAI).

RESULTS

Approximately 40% of the sample was HIV-positive and 63.4% hypertensive, with the greatest risk of hypertension being amongst older men. Based on BMI, 23.0% were overweight and 32.1% obese. Waist-to-height ratio showed that 58.6% had increased cardiovascular risk. Mean BAI was 34.1%, whilst 76.3% had a body fat percentage in the overweight/obese category. Waist circumference representing increased cardiovascular risk was found in 44.3% of women and 3.9% of men. Significant positive correlations between mean arterial bloodpressure and BMI (r = 0.261; p < 0.001), WHtR (r = 0.357; p < 0.001) and BAI (r = 0.245; p <0.001) were found. WHtR was a stronger predictor of mean arterial pressure than BMI or BAI. HIV status showed an inverse correlation with all adiposity indices (p < 0.001).

CONCLUSION

Our findings promote WHtR as a practical screening tool for increased hypertension risk in populations undergoing westernisation, and support weight loss as afirst-line intervention for the prevention and management of hypertension.