Obesity and Hypertension among Urban Affluent Adult Males from Pune, India


Affiliations

  • Agharkar Research Institute, Biometry & Nutrition Unit, Pune, 411 004, India

Abstract

Although hypertension is highly prevalent among urban Indian population, there exists insufficient investigation on its relation with obesity and abdominal obesity indicators for early risk prediction. Data on Body Mass Index (BMI), Body Fat (BF%), Waist Circumference (WC), Abdominal Circumference (AC), Waist to Hip Ratio (WHR), Waist to Height ratio (WHT), Sub-scapular (SSF) and Supra-iliac Skin Folds (SUF) and Blood Pressure were recorded through a cross-sectional study on 302 urban affluent men (aged 30-60 years) in Pune, India. Younger adults had the highest prevalence of both overweight (25.2%) and obesity (52.0%) and age related trend was significant (p<0.05) for prevalence of abdominal obesity. Obesity prevalence based on BF (%) was alarmingly high compared to that based on BMI. Indicators of abdominal obesity (WC, AC, SSF and SUF) increased with increase in BMI. Mean values of SBP and DBP and prevalence of hypertension increased significantly (p<0.05) with increase in BMI, AC, WC and its ratios but not with increase in either BF (%) or skinfolds indicating that it is the distribution of fat and not the total body fat that matters. The risk of hypertension was 2 to 3 times higher for BMI > 27.6 kg/m2, for WC > 91.3 cm, for AC > 97.0 cm and for WHT > 0.55. Optimal cut-off for risk of hypertension obtained by ROC was much lower than conventional cut-off in case of WC (86.3 vs 90 cm) than that for BMI (25.3 vs 25 kg/m2) indicating the need for further studies to validate the potential of simple measurements such as WC and its ratios for risk assessment of hypertension among Indian population.

Keywords

Obesity, Abdominal Obesity, BMI, Waist Circumference, Hypertension.

Subject Discipline

Pulmonology

Full Text:

References

World Health Organization. Global status report on non communicable diseases 2010. WHO, Geneva. 2011, vii.

World Health Organization. Obesity: Preventing and Managing the Global Epidemic: Report of a WHO consultation. WHO Technical Report Series no. 894, WHO, Geneva. 2000, 1-142.

World Health Organization. The Asia-Pacific Perspective: Redefining Obesity and its Treatment. World Health Organization (WHO) / International Association for the Study of Obesity (IASO) / International Obesity Task Force (IOTF). Health Communication Australia PTY Ltd. 2000, 1-25.

Banerji, M.A., Faridi, N., Atluri, R., Rochelle, L. and Lebovitz, H.E., Body composition, visceral fat, leptin and insulin resistance in Asian Indian men. J. Clin. Endocrinol. Metab., 1999, 84, 137-144.

Raji, A., Seely, E.W., Arky, R.A. and Simonson, D.C., Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. J. Clin. Endocrinol. Metab., 2001, 86, 5366-5371.

Deurenberg-Yap, M., Chew, S.K. and Deurenberg, P., Elevated body fat percentage and cardiovascular risks at low body mass index levels among Singaporean Chinese, Malays and Indians. Obes. Rev., 2002, 3, 209-215.

Misra, A. and Vikram, N.K., Insulin resistance syndrome (metabolic syndrome) and Asian Indians. Curr. Sci., 2002, 83, 1483-1496.

Gus, M., Fuchs, S.C., Moreira, L.B., Moraes, R.S., Wiehe, M., Silva, A.F., Albers, F. and Fuchs, F.D., Association between different measurements of obesity and the incidence of hypertension. Am. J. Hypertens., 2004, 17, 50-53.

Siani, A., Cappuccio, F.P., Barba, G., Trevisan, M., Farinaro, E., Iacone, R., Russo, O., Russo, P., Mancini, M. and Strazzullo, P., The Relationship of Waist Circumference to Blood Pressure: The Olivetti Heart Study. Am. J. Hypertens., 2002, 15, 780-786.

Janssen, I., Katzmarzyk, P.T. and Ross, R., Waist circumference and not body mass index explains obesity-related health risk. Am. J. Clin. Nutr., 2004, 79, 379-384.

Yajnik, C.S., Obesity epidemic in India: intrauterine origins? Proc. Nutr. Soc, 2004, 63, 387-396.

Gupta, M., Patil, R., Khan, M.I. and Gupta, S.K., The Prevalence of obesity and hypertension in urban Tamilnadu. J. Clin. Diagn. Res., 2011, 5, 586-588.

Lean, M.E, Han, T.S. and Morrison, L.E., Waist circumference as a measure for indicating need for weight management. BMJ. 1995, 311, 158-161.

Lohman, T.G., Houtkooper, L. and Going, S.B., Body fat measurements goes high tech. (Not all are created equal). ACSM Health Fitness J., 1997, 1, 30-35.

Chobanian, A.V., Bakris, G.L. and Black, H.R., et al., The seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. JAMA, 2003, 289, 2560-2572.

Altaian, D.G., Practical statistics for medical research. London: Chapman & Hall. 1991, 418.

Deurenberg, P., Deurenberg-Yap, M. and Guricci, S., Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obes. Rev., 2002, 3, 141-146.

Sheth, T., Nair, C, Nargundkar, M., Anand, S. and Yusuf, S., Cardiovascular and cancer mortality among Canadians of European, South Asian and Chinese origin from 1979 to 1993: an analysis of 1.2 million deaths. CMAJ, 1999, 161, 132-138.

Enas, E.A., Mohan, V., Deepa, M., Farooq, S., Pazhoor, S. and Chennikkara, H., The metabolic syndrome and dyslipidemia among Asian Indians: A population with high rates of diabetes and premature coronary artery disease. J. Cardio. Metab. Syndr., 2007, 2, 267-275.

Misra, A. and Khurana, L., Obesity related non-communicable diseases: South Asians vs. White Caucasians. I. JOB, 2011, 35, 167-187.

Gopalan, C, Obesity in the Indian Urban 'Middle Class'. NFI Bull, 1998, 19, 1-4.

Chadha, S.L., Gopinath, N. and Shekhawat, S., Urban-rural differences in the prevalence of coronary heart disease and its risk factors in Delhi. Bull World Health Organ., 1997, 75, 31-38.

Ramachandran, A., Snehalatha, C, Dharmaraj, D. and Vishwanathan, M., Prevalance of glucose intolerance in Asian Indians: urban-rural difference and significance of upper body adiposity. Diabetes Care., 1992, 15, 1348-1355.

Gupta, R., Sarna, M., Thanvi, J., Rastogi, P., Kaul, V. and Gupta, V.P., High prevalence of multiple coronary risk factors in Punjabi Bhatia community: Jaipur Heart Watch - 3. Indian Heart J., 2004, 56, 646-652.

Misra, A., Vikram, N.K., Gupta, R., Pandey, R.M., Wasir, J.S. and Gupta, V.P., Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity. Int. J. Obes., 2006, 30, 106-111.

Al-Mahroos, F. and Al-Roomi, K., Obesity among adult Bahraini population: Impact of physical activity and educational level. Ann. Saudi. Med., 2001, 21, 183-187.

Proper, K.I., Cerin, E., Brown, W.J. and Owen, N., Sitting time and socio-economic differences in overweight and obesity. Int. J. Obes., 2007, 31, 169-176.

Singh, R.B., Niaz, M.A., Beegom, R., Wander, G.S., Thakur, A.S. and Rissam, H.S., Body fat per cent by bioelectrical impedance analysis and risk of coronary artery disease among urban men with low rates of obesity: The Indian paradox. J. Am. Coll. Nutr., 1999, 18, 268-273.

Kotani, K., Tokunaga, K., Fujioka, S., Kobatake, T., Keno, Y., Yoshida, S., Shimomura, I., Tarui, S. and Matsuzawa, Y., Sexual dimorphism of age-related changes in whole body fat distribution in the obese. Int. J. Obes., 1994, 18, 207-212.

Zamboni, M., Armellini, F., Milani, M.P., De Marchi, M., Todesco, T., Robbi, R., Bergamo- Andreis, LA. and Bosello, O., Body fat distribution in pre and post menopausal women: Metabolic and anthropometric variables and their inter-relationships. Int. J. Obes., 1992, 16, 495-504.

Kaur, P., Radhakrishnan, E., Rao, S.R., Sankarasubbaiyan, S., Rao, T.V. and Gupte, M.D., The Metabolic Syndrome and associated risk factors in an urban industrial male population in South India. J. Assoc. Physicians India., 2010, 58, 363-366.

Menke, A., Muntner, P., Wildman, R.P., Reynolds, K. and He, J., Measures of adiposity and cardiovascular disease risk factors. Obesity., 2007, 15, 785-795.

Friedl, K.E., Waist Circumference threshold values for Type 2 diabetes risk. J. Diabet. Sci. Technol., 2009, 3, 761-769.

Bhadra, M., Mukhopadhyay, A. and Bose, K., Adiposity, central body fat distribution and blood pressure among young Bengalee adults of Kolkatta, India: Sexual dimorphism. J. Physiol. Anthropol., 2002, 21, 273-276.


Refbacks

  • There are currently no refbacks.