Association of Obesity Indicators with Hypertension in Type 2 Diabetes Mellitus Patients

Ghulam Mohyud Din Chaudhary; Asim Tameez Ud Din; Farooq Mohyud Din Chaudhary; Azfar Tanveer; Khaleeq H Siddiqui; Asma Tameez Ud Din; Noman A Chaudhary; Sana Mohyud Din Chaudhary; Ahsan Tameez-Ud-Din; Faisal Nawaz

doi:10.7759/cureus.5050

Association of Obesity Indicators with Hypertension in Type 2 Diabetes Mellitus Patients

Cureus. 2019 Jul 1;11(7):e5050. doi: 10.7759/cureus.5050.

Affiliations

¹ Internal Medicine, Nishtar Medical University & Hospital, Multan, PAK.
² Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK.
³ Gastroenterology, Nishtar Medical University & Hospital, Multan, PAK.
⁴ Internal Medicine, NewYork-Presbyterian Queens, Flushing, USA.
⁵ Surgery, Rawalpindi Medical University, Rawalpindi, PAK.
⁶ Internal Medicine, Combined Military Hospital Lahore Medical College & Institute of Dentistry, Lahore, PAK.
⁷ Gastroenterology, Good Hope Hospital, University Hospitals Birmingham, Birmingham, GBR.

Abstract

Objectives: To study the association of waist circumference (WC), waist to hip ratio (WHR) and body mass index (BMI) with hypertension in type 2 diabetes mellitus (DM) patients in a tertiary care hospital.

Methods: The anthropometric measures of patients were recorded in the Diabetic Outdoor of Nishtar Hospital Multan from 2013 to 2018 after taking approval from the Institutional Ethical Review Committee. All patients were evaluated in detail after obtaining informed consent. Data was entered and analyzed in SPSS version 20 (IBM Corp., Armonk, NY, USA).

Results: Data of 4556 type 2 DM patients, 2549 (55.9%) females, and 2007 (44.1%) males, was analyzed. Mean age of the study population was 47.72 years. Mean age of females was 47.32 years, while of males was 48.23 years. A total of 3393 (74.5%) of the patients had hypertension, 1912 females and 1481 males. The mean systolic blood pressure (SBP) was 130.84 mmHg, while the mean diastolic blood pressure (DBP) was 82.65 mmHg. Mean WC was 102.85 cm. Mean hip circumference was 100.33 cm. Mean weight was 66.93 kg. Mean height was 1.59 m. Mean WHR was 1.02. Mean BMI was 26.37 kg/m2. Obesity (BMI >27 kg/m2) was found in 1,891 (41.5%) of patients. Central obesity was found in 80.7% and 94.7% of type 2 DM patients according to the WC and WHR cutoff, respectively. Hypertension was significantly associated with all the obesity indicators (p<0.001). Type 2 DM patients with a high WHR were more likely to be hypertensive as compared to those with normal WHR (75% versus 65%, odds ratio (OR) 1.6, p<0.001). A higher than normal WC was also significantly associated with hypertension (79% versus 56%, OR 2.9, p<0.001). Similarly, obese type 2 DM patients with a BMI >27 kg/m2 were more likely to be hypertensive as compared to those with a normal range (18.5 to 22.9 kg/m2) BMI (83.1% versus 64.4%, OR 2.7, p<0.001).

Conclusion: Diabetes is more prevalent in females and middle-aged people. Hypertension and obesity are two very common comorbidities of diabetes. Hypertension is strongly associated with all the parameters (WC, WHR, and BMI) of obesity.

Keywords: body mass index; hypertension; obesity; type 2 diabetes mellitus; waist circumference; waist to hip ratio.