The association between body mass index and abdominal obesity with hypertension among South Asian population: findings from nationally representative surveys

Rajat Das Gupta; Ateeb Ahmad Parray; Rohan Jay Kothadia; Orindom Shing Pulock; Susmita Dey Pinky; Shams Shabab Haider; Maxwell Akonde; Mohammad Rifat Haider

doi:10.1186/s40885-023-00257-2

The association between body mass index and abdominal obesity with hypertension among South Asian population: findings from nationally representative surveys

Clin Hypertens. 2024 Feb 1;30(1):3. doi: 10.1186/s40885-023-00257-2.

Authors

Rajat Das Gupta¹, Ateeb Ahmad Parray², Rohan Jay Kothadia³, Orindom Shing Pulock⁴, Susmita Dey Pinky⁵, Shams Shabab Haider⁶, Maxwell Akonde⁷, Mohammad Rifat Haider⁸

Affiliations

¹ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. rajatdas@email.sc.edu.
² Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615N Wolfe St, Baltimore, MD, 21205, USA.
³ Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
⁴ Department of Medicine, Chittagong Medical College Hospital, K B Fazlul Kader Road, Panchlaish, Chattogram, 4203, Bangladesh.
⁵ Department of Cardiology, Hammersmith Hospital, Imperial College NHS Healthcare Trust, London, W12 0HS, UK.
⁶ Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD, 21205, USA.
⁷ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
⁸ Department of Health Policy and Management, College of Public Health, University of Georgia, Wright Hall 301B 100 Foster Rd, Athens, GA, 30602, USA.

Abstract

Objective: This study aimed to determine the association between body mass index (BMI) and abdominal obesity with hypertension among the South Asian adults (18-69 years).

Methods: This study utilized the nationally representative WHO STEPwise approach to surveillance data (n = 24,413) from Afghanistan, Bangladesh, Bhutan, Nepal, and Sri Lanka. Hypertension was defined as having a systolic blood pressure of 140 mmHg or higher, a diastolic blood pressure of 90 mmHg or higher, and/or taking antihypertensive medications. A waist circumference ≥ 90 cm in men and ≥ 80 cm in women was considered as abdominal obesity. BMI was categorized according to Asia-specific cutoff and overweight was defined as BMI of 23.0-27.5 kg/m² and obesity was defined as BMI ≥ 27.5 kg/m². Multivariable logistic regression analyses were conducted to identify the association between BMI and abdominal obesity with hypertension. The odds ratio (OR) with a 95% confidence interval (CI) was reported.

Results: Abdominal obesity increased the odds of hypertension 31%-105% compared to those who did not have abdominal obesity (OR: Afghanistan: 2.05; 95% CI: 1.27-3.31; Bangladesh: 1.55; 95% CI: 1.18-2.04; Bhutan: 1.31; 95% CI: 1.03-1.66; Nepal: 1.69; 95% CI: 1.31-2.18; Sri Lanka:1.55; 95% CI: 1.23-1.95). The odds increased among participants with both overweight/obesity and abdominal obesity. In all five countries under study, participants with both overweight and abdominal obesity (OR: Afghanistan: 2.75; 95% CI: 1.75-4.34; Bangladesh: 2.53; 95% CI: 1.90-3.37; Bhutan: 2.22; 95% CI: 1.64-3.00; Nepal: 2.08; 95% CI: 1.54-2.81; Sri Lanka: 2.29; 95% CI: 1.77-2.98), as well as those with obesity and abdominal obesity (OR: Afghanistan: 6.94; 95% CI: 4.68-10.30; Bangladesh: 2.95; 95% CI: 2.19-3.97; Bhutan: 3.02; 95% CI: 2.23-4.09; Nepal: 4.40; 95% CI: 3.05-6.34; Sri Lanka: 3.96; 95% CI: 2.94-5.32), exhibited higher odds of having hypertension as compared to participants with a normal BMI and no abdominal obesity.

Conclusion: Having both abdominal obesity and overweight/obesity increased the odds of hypertension among South Asian adults. Preventing overweight/obesity and abdominal obesity is necessary for preventing the burden of hypertension in South Asia.

Keywords: Abdominal obesity; Hypertension; Obesity.