Abstract
As a major cause of various cardiovascular diseases, the prevalence of hypertension has been increasing in the past 30 years, leading to significant socioeconomic and health burdens. Obesity is one of the major risk factors for hypertension. Body mass index (BMI) is the most used anthropometric index to measure obesity in clinical practice and to assess the risk of obesity-related diseases. However, obesity is a heterogeneous disease, and the accumulation of fat in different body regions leads to differences in cardiovascular and metabolic risks. BMI only reflects the overall obesity but does not consider the distribution of fat and muscle mass. The limitation of BMI makes it insufficient to assess the risk of hypertension attributed to obesity. In addition, waist circumference is an easily obtainable anthropometric index to evaluate abdominal fat distribution. High waist circumference is an independent risk factor for various cardiovascular diseases and all-cause mortality regardless of BMI. Preliminary data indicate that waist circumference is significantly associated with the risk of hypertension at different BMI levels. However, routine measurement of waist circumference is currently not required in current clinical guidelines or is only recommended for obese populations, indicating an insufficient understanding of waist circumference. In this review, we summarize the measurement methods and diagnostic thresholds of waist circumference for abdominal obesity, the trend of central obesity prevalence, the superiority of waist circumference over other anthropometric indices, and recent cross-sectional and longitudinal studies on the association between obesity and hypertension.
Graphical Abstract
[1]
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: Executive summary: A report of the American college of cardiology/American heart association task force on clinical practice guidelines. Circulation 2018; 138(17): e426-83.
[PMID: 30354655]
[PMID: 30354655]
[2]
Umemura S, Arima H, Arima S, et al. The japanese society of hypertension guidelines for the management of hypertension (JSH 2019). Hypertens Res 2019; 42(9): 1235-481.
[http://dx.doi.org/10.1038/s41440-019-0284-9] [PMID: 31375757]
[http://dx.doi.org/10.1038/s41440-019-0284-9] [PMID: 31375757]
[3]
Williams B, Mancia G, Spiering W, et al. 2018 practice guidelines for the management of arterial hypertension of the european society of hypertension and the European society of cardiology: ESH/ESC task force for the management of arterial hypertension. J Hypertens 2018; 36(12): 2284-309.
[http://dx.doi.org/10.1097/HJH.0000000000001961] [PMID: 30379783]
[http://dx.doi.org/10.1097/HJH.0000000000001961] [PMID: 30379783]
[4]
Unger T, Borghi C, Charchar F. 2020 international society of hypertension global hypertension practice guidelines. Hypertension 2020; 75(6): 1334-57.
[5]
Wang JG, Zhang W, Li Y, Liu L. Hypertension in China: Epidemiology and treatment initiatives. Nat Rev Cardiol 2023; 20(8): 531-45.
[http://dx.doi.org/10.1038/s41569-022-00829-z] [PMID: 36631532]
[http://dx.doi.org/10.1038/s41569-022-00829-z] [PMID: 36631532]
[6]
Zhou B, Carrillo-Larco RM, Danaei G, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. Lancet 2021; 398(10304): 957-80.
[http://dx.doi.org/10.1016/S0140-6736(21)01330-1] [PMID: 34450083]
[http://dx.doi.org/10.1016/S0140-6736(21)01330-1] [PMID: 34450083]
[7]
Wang Z, Chen Z, Zhang L, et al. Status of Hypertension in China. Circulation 2018; 137(22): 2344-56.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.117.032380] [PMID: 29449338]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.117.032380] [PMID: 29449338]
[8]
Li R, Li Q, Zhang S, et al. Domestic physical activity and new-onset hypertension: A nationwide cohort study in China. Am J Med 2022; 135(11): 1362-1370.e6.
[http://dx.doi.org/10.1016/j.amjmed.2022.04.023] [PMID: 35584787]
[http://dx.doi.org/10.1016/j.amjmed.2022.04.023] [PMID: 35584787]
[9]
Sun JY, Ma YX, Liu HL, et al. High waist circumference is a risk factor of new‐onset hypertension: Evidence from the china health and retirement longitudinal study. J Clin Hypertens 2022; 24(3): 320-8.
[http://dx.doi.org/10.1111/jch.14446] [PMID: 35188335]
[http://dx.doi.org/10.1111/jch.14446] [PMID: 35188335]
[10]
Sun W, Wang Y, Zhang H, et al. eHypertension: A prospective longitudinal multi‐omics essential hypertension cohort. iMeta 2022; 1(2): e22.
[http://dx.doi.org/10.1002/imt2.22]
[http://dx.doi.org/10.1002/imt2.22]
[11]
Seidell JC, Halberstadt J. The global burden of obesity and the challenges of prevention. Ann Nutr Metab 2015; 66 (Suppl. 2): 7-12.
[http://dx.doi.org/10.1159/000375143]
[http://dx.doi.org/10.1159/000375143]
[12]
Blüher M. Obesity: Global epidemiology and pathogenesis. Nat Rev Endocrinol 2019; 15(5): 288-98.
[http://dx.doi.org/10.1038/s41574-019-0176-8] [PMID: 30814686]
[http://dx.doi.org/10.1038/s41574-019-0176-8] [PMID: 30814686]
[13]
Afshin A, Forouzanfar MH, Reitsma MB, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 2017; 377(1): 13-27.
[http://dx.doi.org/10.1056/NEJMoa1614362] [PMID: 28604169]
[http://dx.doi.org/10.1056/NEJMoa1614362] [PMID: 28604169]
[14]
Abarca-Gómez L, Abdeen ZA, Hamid ZA, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017; 390(10113): 2627-42.
[http://dx.doi.org/10.1016/S0140-6736(17)32129-3] [PMID: 29029897]
[http://dx.doi.org/10.1016/S0140-6736(17)32129-3] [PMID: 29029897]
[15]
World Health Organization. Obesity and overweight [Internet] Geneva: WHO; 2020 [cited 2021 Jan 21]. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
[16]
Garrison RJ, Kannel WB, Stokes J III, Castelli WP. Incidence and precursors of hypertension in young adults: The Framingham offspring study. Prev Med 1987; 16(2): 235-51.
[http://dx.doi.org/10.1016/0091-7435(87)90087-9] [PMID: 3588564]
[http://dx.doi.org/10.1016/0091-7435(87)90087-9] [PMID: 3588564]
[17]
Brauer P, Gorber SC, Shaw E. Recommendations for prevention of weight gain and use of behavioural and pharmacologic interventions to manage overweight and obesity in adults in primary care. CMAJ 2015; 187(3): 184-95.
[http://dx.doi.org/10.1503/cmaj.140887]
[http://dx.doi.org/10.1503/cmaj.140887]
[18]
Garvey WT, Mechanick JI, Brett EM. American association of clinical endocrinologists and American college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract 2016; 22 (Suppl 3): 1-203.
[19]
Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults. Circulation 2014; 129((25_suppl_2)(Suppl. 2)): S102-38.
[http://dx.doi.org/10.1161/01.cir.0000437739.71477.ee] [PMID: 24222017]
[http://dx.doi.org/10.1161/01.cir.0000437739.71477.ee] [PMID: 24222017]
[20]
Tsigos C, Hainer V, Basdevant A, et al. Management of obesity in adults: European clinical practice guidelines. Obes Facts 2008; 1(2): 106-16.
[http://dx.doi.org/10.1159/000126822] [PMID: 20054170]
[http://dx.doi.org/10.1159/000126822] [PMID: 20054170]
[21]
Ross R, Berentzen T, Bradshaw AJ, et al. Does the relationship between waist circumference, morbidity and mortality depend on measurement protocol for waist circumference? Obes Rev 2008; 9(4): 312-25.
[http://dx.doi.org/10.1111/j.1467-789X.2007.00411.x] [PMID: 17956544]
[http://dx.doi.org/10.1111/j.1467-789X.2007.00411.x] [PMID: 17956544]
[22]
Hirsch JA, Moore KA, Barrientos-Gutierrez T, et al. Built environment change and change in BMI and waist circumference: Multi-ethnic study of atherosclerosis. Obesity 2014; 22(11): 2450-7.
[http://dx.doi.org/10.1002/oby.20873] [PMID: 25136965]
[http://dx.doi.org/10.1002/oby.20873] [PMID: 25136965]
[23]
Rexrode KM, Carey VJ, Hennekens CH, et al. Abdominal adiposity and coronary heart disease in women. JAMA 1998; 280(21): 1843-8.
[http://dx.doi.org/10.1001/jama.280.21.1843] [PMID: 9846779]
[http://dx.doi.org/10.1001/jama.280.21.1843] [PMID: 9846779]
[24]
Wang J, Thornton JC, Bari S, et al. Comparisons of waist circumferences measured at 4 sites. Am J Clin Nutr 2003; 77(2): 379-84.
[http://dx.doi.org/10.1093/ajcn/77.2.379] [PMID: 12540397]
[http://dx.doi.org/10.1093/ajcn/77.2.379] [PMID: 12540397]
[25]
Mason C, Katzmarzyk PT. Variability in waist circumference measurements according to anatomic measurement site. Obesity 2009; 17(9): 1789-95.
[http://dx.doi.org/10.1038/oby.2009.87] [PMID: 19343017]
[http://dx.doi.org/10.1038/oby.2009.87] [PMID: 19343017]
[26]
Lean MEJ, Han TS, Morrison CE. Waist circumference as a measure for indicating need for weight management. BMJ 1995; 311(6998): 158-61.
[http://dx.doi.org/10.1136/bmj.311.6998.158] [PMID: 7613427]
[http://dx.doi.org/10.1136/bmj.311.6998.158] [PMID: 7613427]
[27]
Alberti KGMM, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome. Circulation 2009; 120(16): 1640-5.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192644] [PMID: 19805654]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192644] [PMID: 19805654]
[28]
Cerhan JR, Moore SC, Jacobs EJ, et al. A pooled analysis of waist circumference and mortality in 650,000 adults. Mayo Clin Proc 2014; 89(3): 335-45.
[http://dx.doi.org/10.1016/j.mayocp.2013.11.011] [PMID: 24582192]
[http://dx.doi.org/10.1016/j.mayocp.2013.11.011] [PMID: 24582192]
[29]
Snijder MB, van Dam RM, Visser M, Seidell JC. What aspects of body fat are particularly hazardous and how do we measure them? Int J Epidemiol 2006; 35(1): 83-92.
[http://dx.doi.org/10.1093/ije/dyi253] [PMID: 16339600]
[http://dx.doi.org/10.1093/ije/dyi253] [PMID: 16339600]
[30]
Ardern CI, Janssen I, Ross R, Katzmarzyk PT. Development of health-related waist circumference thresholds within BMI categories. Obes Res 2004; 12(7): 1094-103.
[http://dx.doi.org/10.1038/oby.2004.137] [PMID: 15292473]
[http://dx.doi.org/10.1038/oby.2004.137] [PMID: 15292473]
[31]
Bajaj HS, Brennan DM, Hoogwerf BJ, Doshi KB, Kashyap SR. Clinical utility of waist circumference in predicting all-cause mortality in a preventive cardiology clinic population: A PreCIS Database Study. Obesity 2009; 17(8): 1615-20.
[http://dx.doi.org/10.1038/oby.2009.44] [PMID: 19265793]
[http://dx.doi.org/10.1038/oby.2009.44] [PMID: 19265793]
[32]
Fontes F, Damasceno A, Jessen N, et al. Prevalence of overweight and obesity in Mozambique in 2005 and 2015. Public Health Nutr 2019; 22(17): 3118-26.
[http://dx.doi.org/10.1017/S1368980019002325] [PMID: 31453793]
[http://dx.doi.org/10.1017/S1368980019002325] [PMID: 31453793]
[33]
Turé R, Damasceno A, Djicó M, Lunet N. Prevalence of underweight, overweight and obesity among adults in urban bissau, Western Africa. Nutrients 2021; 13(12): 4199.
[http://dx.doi.org/10.3390/nu13124199] [PMID: 34959751]
[http://dx.doi.org/10.3390/nu13124199] [PMID: 34959751]
[34]
Jia A, Xu S, Xing Y, et al. Prevalence and cardiometabolic risks of normal weight obesity in Chinese population: A nationwide study. Nutr Metab Cardiovasc Dis 2018; 28(10): 1045-53.
[http://dx.doi.org/10.1016/j.numecd.2018.06.015] [PMID: 30143410]
[http://dx.doi.org/10.1016/j.numecd.2018.06.015] [PMID: 30143410]
[35]
Sun JY, Huang WJ, Hua Y, et al. Trends in general and abdominal obesity in US adults: Evidence from the national health and nutrition examination survey (2001–2018). Front Public Health 2022; 10: 925293.
[http://dx.doi.org/10.3389/fpubh.2022.925293] [PMID: 36276394]
[http://dx.doi.org/10.3389/fpubh.2022.925293] [PMID: 36276394]
[36]
Li Y, Teng D, Shi X, et al. Changes in the prevalence of obesity and hypertension and demographic risk factor profiles in China over 10 years: Two national cross-sectional surveys. Lancet Regional Health - Western Pacific 2021; 15: 100227.
[http://dx.doi.org/10.1016/j.lanwpc.2021.100227] [PMID: 34528008]
[http://dx.doi.org/10.1016/j.lanwpc.2021.100227] [PMID: 34528008]
[37]
Janssen I, Shields M, Craig CL, Tremblay MS. Changes in the obesity phenotype within Canadian children and adults, 1981 to 2007-2009. Obesity 2012; 20(4): 916-9.
[http://dx.doi.org/10.1038/oby.2011.122] [PMID: 21566567]
[http://dx.doi.org/10.1038/oby.2011.122] [PMID: 21566567]
[38]
Albrecht SS, Gordon-Larsen P, Stern D, Popkin BM. Is waist circumference per body mass index rising differentially across the United States, England, China and Mexico? Eur J Clin Nutr 2015; 69(12): 1306-12.
[http://dx.doi.org/10.1038/ejcn.2015.71] [PMID: 25944180]
[http://dx.doi.org/10.1038/ejcn.2015.71] [PMID: 25944180]
[39]
Visscher TLS, Heitmann BL, Rissanen A, Lahti-Koski M, Lissner L. A break in the obesity epidemic? Explained by biases or misinterpretation of the data? Int J Obes 2015; 39(2): 189-98.
[http://dx.doi.org/10.1038/ijo.2014.98] [PMID: 24909829]
[http://dx.doi.org/10.1038/ijo.2014.98] [PMID: 24909829]
[40]
Dwivedi AK, Dubey P, Cistola DP, Reddy SY. Association between obesity and cardiovascular outcomes: Updated evidence from meta-analysis studies. Curr Cardiol Rep 2020; 22(4): 25.
[http://dx.doi.org/10.1007/s11886-020-1273-y] [PMID: 32166448]
[http://dx.doi.org/10.1007/s11886-020-1273-y] [PMID: 32166448]
[41]
Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: A systematic review and meta-analysis. JAMA 2013; 309(1): 71-82.
[http://dx.doi.org/10.1001/jama.2012.113905] [PMID: 23280227]
[http://dx.doi.org/10.1001/jama.2012.113905] [PMID: 23280227]
[42]
Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003; 348(17): 1625-38.
[http://dx.doi.org/10.1056/NEJMoa021423] [PMID: 12711737]
[http://dx.doi.org/10.1056/NEJMoa021423] [PMID: 12711737]
[43]
Shihab HM, Meoni LA, Chu AY, et al. Body mass index and risk of incident hypertension over the life course: The johns hopkins precursors study. Circulation 2012; 126(25): 2983-9.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.112.117333] [PMID: 23151344]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.112.117333] [PMID: 23151344]
[44]
Pandey A, Patel KV, Bahnson JL, et al. Association of intensive lifestyle intervention, fitness, and body mass index with risk of heart failure in overweight or obese adults with type 2 diabetes mellitus. Circulation 2020; 141(16): 1295-306.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.119.044865] [PMID: 32134326]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.119.044865] [PMID: 32134326]
[45]
Romero-Corral A, Montori VM, Somers VK, et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: A systematic review of cohort studies. Lancet 2006; 368(9536): 666-78.
[http://dx.doi.org/10.1016/S0140-6736(06)69251-9] [PMID: 16920472]
[http://dx.doi.org/10.1016/S0140-6736(06)69251-9] [PMID: 16920472]
[46]
Coutinho T, Goel K, Corrêa de Sá D, et al. Central obesity and survival in subjects with coronary artery disease: A systematic review of the literature and collaborative analysis with individual subject data. J Am Coll Cardiol 2011; 57(19): 1877-86.
[http://dx.doi.org/10.1016/j.jacc.2010.11.058] [PMID: 21545944]
[http://dx.doi.org/10.1016/j.jacc.2010.11.058] [PMID: 21545944]
[47]
Ding L, Fan Y, He J, et al. Different indicators of adiposity and fat distribution and cardiometabolic risk factors in patients with type 2 diabetes. Obesity 2021; 29(5): 837-45.
[http://dx.doi.org/10.1002/oby.23151] [PMID: 33899339]
[http://dx.doi.org/10.1002/oby.23151] [PMID: 33899339]
[48]
Liu BX, Sun W, Kong XQ. Perirenal fat: A unique fat pad and potential target for cardiovascular disease. Angiology 2019; 70(7): 584-93.
[http://dx.doi.org/10.1177/0003319718799967] [PMID: 30301366]
[http://dx.doi.org/10.1177/0003319718799967] [PMID: 30301366]
[49]
Tchernof A, Després JP. Pathophysiology of human visceral obesity: An update. Physiol Rev 2013; 93(1): 359-404.
[http://dx.doi.org/10.1152/physrev.00033.2011] [PMID: 23303913]
[http://dx.doi.org/10.1152/physrev.00033.2011] [PMID: 23303913]
[50]
Kissebah AH, Vydelingum N, Murray R, et al. Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab 1982; 54(2): 254-60.
[http://dx.doi.org/10.1210/jcem-54-2-254] [PMID: 7033275]
[http://dx.doi.org/10.1210/jcem-54-2-254] [PMID: 7033275]
[51]
Krotkiewski M, Björntorp P, Sjöström L, Smith U. Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution. J Clin Invest 1983; 72(3): 1150-62.
[http://dx.doi.org/10.1172/JCI111040] [PMID: 6350364]
[http://dx.doi.org/10.1172/JCI111040] [PMID: 6350364]
[52]
Hartz A, Rupley DC Jr, Kalkhoff RD, Rimm AA. Relationship of obesity to diabetes: Influence of obesity level and body fat distribution. Prev Med 1983; 12(2): 351-7.
[http://dx.doi.org/10.1016/0091-7435(83)90244-X] [PMID: 6878197]
[http://dx.doi.org/10.1016/0091-7435(83)90244-X] [PMID: 6878197]
[53]
Larsson B, Svärdsudd K, Welin L, Wilhelmsen L, Björntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. BMJ 1984; 288(6428): 1401-4.
[http://dx.doi.org/10.1136/bmj.288.6428.1401] [PMID: 6426576]
[http://dx.doi.org/10.1136/bmj.288.6428.1401] [PMID: 6426576]
[54]
Allison DB, Paultre F, Goran MI. Statistical considerations regarding the use of ratios to adjust data. International Journal of Obesity and Related Metabolic Disorders. Journal of the International Association For the Study of Obesity 1995; 19(9): 644-52.
[55]
Zong X, Kelishadi R, Hong YM, et al. Establishing international optimal cut-offs of waist-to-height ratio for predicting cardiometabolic risk in children and adolescents aged 6–18 years. BMC Med 2023; 21(1): 442.
[http://dx.doi.org/10.1186/s12916-023-03169-y] [PMID: 37968681]
[http://dx.doi.org/10.1186/s12916-023-03169-y] [PMID: 37968681]
[56]
Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med 2008; 359(20): 2105-20.
[http://dx.doi.org/10.1056/NEJMoa0801891] [PMID: 19005195]
[http://dx.doi.org/10.1056/NEJMoa0801891] [PMID: 19005195]
[57]
Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: Sixteen years of follow-up in US women. Circulation 2008; 117(13): 1658-67.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.107.739714] [PMID: 18362231]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.107.739714] [PMID: 18362231]
[58]
Song X, Jousilahti P, Stehouwer CDA, et al. Comparison of various surrogate obesity indicators as predictors of cardiovascular mortality in four European populations. Eur J Clin Nutr 2013; 67(12): 1298-302.
[http://dx.doi.org/10.1038/ejcn.2013.203] [PMID: 24149442]
[http://dx.doi.org/10.1038/ejcn.2013.203] [PMID: 24149442]
[59]
Sun JY, Hua Y, Zou HYY, et al. Association between waist circumference and the prevalence of (Pre) hypertension among 27,894 US adults. Front Cardiovasc Med 2021; 8: 717257.
[http://dx.doi.org/10.3389/fcvm.2021.717257] [PMID: 34712705]
[http://dx.doi.org/10.3389/fcvm.2021.717257] [PMID: 34712705]
[60]
Sun J, Qu Q, Yuan Y, Sun G, Kong X, Sun W. Normal-weight abdominal obesity: A risk factor for hypertension and cardiometabolic dysregulation. Cardiology Discovery 2022; 2(1): 13-21.
[http://dx.doi.org/10.1097/CD9.0000000000000034]
[http://dx.doi.org/10.1097/CD9.0000000000000034]
[61]
Yin YH, Zhou SY, Lu DF, et al. Higher waist circumference is associated with increased likelihood of female infertility: NHANES 2017-2020 results. Front Endocrinol 2023; 14: 1216413.
[http://dx.doi.org/10.3389/fendo.2023.1216413] [PMID: 37937052]
[http://dx.doi.org/10.3389/fendo.2023.1216413] [PMID: 37937052]
[62]
Campbell DJ, Gong FF, Jelinek MV, et al. Threshold body mass index and sex-specific waist circumference for increased risk of heart failure with preserved ejection fraction. Eur J Prev Cardiol 2019; 26(15): 1594-602.
[http://dx.doi.org/10.1177/2047487319851298] [PMID: 31104485]
[http://dx.doi.org/10.1177/2047487319851298] [PMID: 31104485]
[63]
Hong Y, Jin X, Mo J, et al. Metabolic syndrome, its preeminent clusters, incident coronary heart disease and all‐cause mortality – results of prospective analysis for the Atherosclerosis Risk in Communities study. J Intern Med 2007; 262(1): 113-22.
[http://dx.doi.org/10.1111/j.1365-2796.2007.01781.x] [PMID: 17598819]
[http://dx.doi.org/10.1111/j.1365-2796.2007.01781.x] [PMID: 17598819]
[64]
Wei J, Liu X, Xue H, Wang Y, Shi Z. Comparisons of visceral adiposity index, body shape index, body mass index and waist circumference and their associations with diabetes mellitus in adults. Nutrients 2019; 11(7): 1580.
[http://dx.doi.org/10.3390/nu11071580] [PMID: 31336951]
[http://dx.doi.org/10.3390/nu11071580] [PMID: 31336951]
[65]
Sheng G, Lu S, Xie Q, Peng N, Kuang M, Zou Y. The usefulness of obesity and lipid-related indices to predict the presence of Non-alcoholic fatty liver disease. Lipids Health Dis 2021; 20(1): 134.
[http://dx.doi.org/10.1186/s12944-021-01561-2] [PMID: 34629059]
[http://dx.doi.org/10.1186/s12944-021-01561-2] [PMID: 34629059]
[66]
Carmienke S, Freitag MH, Pischon T, et al. General and abdominal obesity parameters and their combination in relation to mortality: A systematic review and meta-regression analysis. Eur J Clin Nutr 2013; 67(6): 573-85.
[http://dx.doi.org/10.1038/ejcn.2013.61] [PMID: 23511854]
[http://dx.doi.org/10.1038/ejcn.2013.61] [PMID: 23511854]
[67]
Garvey WT, Mechanick JI. Proposal for a scientifically correct and medically actionable disease classification system (ICD) for obesity. Obesity 2020; 28(3): 484-92.
[http://dx.doi.org/10.1002/oby.22727] [PMID: 32090513]
[http://dx.doi.org/10.1002/oby.22727] [PMID: 32090513]
[68]
de Hollander EL, Bemelmans WJ, Boshuizen HC, et al. The association between waist circumference and risk of mortality considering body mass index in 65- to 74-year-olds: A meta-analysis of 29 cohorts involving more than 58 000 elderly persons. Int J Epidemiol 2012; 41(3): 805-17.
[http://dx.doi.org/10.1093/ije/dys008] [PMID: 22467292]
[http://dx.doi.org/10.1093/ije/dys008] [PMID: 22467292]
[69]
Janssen I, Katzmarzyk PT, Ross R. Body mass index is inversely related to mortality in older people after adjustment for waist circumference. J Am Geriatr Soc 2005; 53(12): 2112-8.
[http://dx.doi.org/10.1111/j.1532-5415.2005.00505.x] [PMID: 16398895]
[http://dx.doi.org/10.1111/j.1532-5415.2005.00505.x] [PMID: 16398895]
[70]
Bigaard J, Tjønneland A, Thomsen BL, Overvad K, Heitmann BL, Sørensen TIA. Waist circumference, BMI, smoking, and mortality in middle-aged men and women. Obes Res 2003; 11(7): 895-903.
[http://dx.doi.org/10.1038/oby.2003.123] [PMID: 12855760]
[http://dx.doi.org/10.1038/oby.2003.123] [PMID: 12855760]
[71]
Ross R, Neeland IJ, Yamashita S, et al. Waist circumference as a vital sign in clinical practice: A Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol 2020; 16(3): 177-89.
[http://dx.doi.org/10.1038/s41574-019-0310-7] [PMID: 32020062]
[http://dx.doi.org/10.1038/s41574-019-0310-7] [PMID: 32020062]
[72]
Klein S, Allison DB, Heymsfield SB, et al. Waist circumference and cardiometabolic risk. Diabetes Care 2007; 30(6): 1647-52.
[http://dx.doi.org/10.2337/dc07-9921] [PMID: 17360974]
[http://dx.doi.org/10.2337/dc07-9921] [PMID: 17360974]
[73]
Rao G, Powell-Wiley TM, Ancheta I, et al. Identification of obesity and cardiovascular risk in ethnically and racially diverse populations. Circulation 2015; 132(5): 457-72.
[http://dx.doi.org/10.1161/CIR.0000000000000223] [PMID: 26149446]
[http://dx.doi.org/10.1161/CIR.0000000000000223] [PMID: 26149446]
[74]
Coutinho T, Goel K, Corrêa de Sá D, et al. Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: Role of “normal weight central obesity”. J Am Coll Cardiol 2013; 61(5): 553-60.
[http://dx.doi.org/10.1016/j.jacc.2012.10.035] [PMID: 23369419]
[http://dx.doi.org/10.1016/j.jacc.2012.10.035] [PMID: 23369419]
[75]
Zhang M, Zhao Y, Wang G, et al. Body mass index and waist circumference combined predicts obesity-related hypertension better than either alone in a rural Chinese population. Sci Rep 2016; 6(1): 31935.
[http://dx.doi.org/10.1038/srep31935] [PMID: 27545898]
[http://dx.doi.org/10.1038/srep31935] [PMID: 27545898]
[76]
Yang M, Zhang Y, Zhao W, et al. Individual and combined associations of body mass index and waist circumference with components of metabolic syndrome among multiethnic middle-aged and older adults: A cross-sectional study. Front Endocrinol 2023; 14: 1078331.
[http://dx.doi.org/10.3389/fendo.2023.1078331] [PMID: 36909310]
[http://dx.doi.org/10.3389/fendo.2023.1078331] [PMID: 36909310]
[77]
Wang YH, Hua Y, Zhang HZ, et al. Ratio of waist circumference to body mass index: A novel predictor of clinical outcome in hypertension patients. J Clin Hypertens 2024; 26(1): 24-35.
[http://dx.doi.org/10.1111/jch.14739] [PMID: 37864476]
[http://dx.doi.org/10.1111/jch.14739] [PMID: 37864476]
[78]
Sahakyan KR, Somers VK, Rodriguez-Escudero JP, et al. Normal-weight central obesity: Implications for total and cardiovascular mortality. Ann Intern Med 2015; 163(11): 827-35.
[http://dx.doi.org/10.7326/M14-2525] [PMID: 26551006]
[http://dx.doi.org/10.7326/M14-2525] [PMID: 26551006]
[79]
Cheng C, Sun JY, Zhou Y, et al. High waist circumference is a risk factor for hypertension in normal‐weight or overweight individuals with normal metabolic profiles. J Clin Hypertens 2022; 24(7): 908-17.
[http://dx.doi.org/10.1111/jch.14528] [PMID: 35739356]
[http://dx.doi.org/10.1111/jch.14528] [PMID: 35739356]
[80]
Li B, Wang J, Zhou X, et al. Chinese visceral adiposity index is more closely associated with hypertension and prehypertension than traditional adiposity indices in chinese population: Results from the reaction study. Front Endocrinol 2022; 13: 921997.
[http://dx.doi.org/10.3389/fendo.2022.921997] [PMID: 35846316]
[http://dx.doi.org/10.3389/fendo.2022.921997] [PMID: 35846316]
[81]
Zhao P, Shi W, Shi Y, et al. Positive association between weight-adjusted-waist index and hyperuricemia in patients with hypertension: The China H-type hypertension registry study. Front Endocrinol 2022; 13: 1007557.
[http://dx.doi.org/10.3389/fendo.2022.1007557] [PMID: 36277696]
[http://dx.doi.org/10.3389/fendo.2022.1007557] [PMID: 36277696]
[82]
Katchunga PB, Bapolisi AM, M’Buyamba-Kabangu JR, Hermans MP. Bioelectrical impedance outperforms waist circumference for predicting cardiometabolic risk in Congolese hypertensive subjects: a cross-sectional study. BMC Cardiovasc Disord 2015; 15(1): 17.
[http://dx.doi.org/10.1186/s12872-015-0011-7] [PMID: 25887798]
[http://dx.doi.org/10.1186/s12872-015-0011-7] [PMID: 25887798]
[83]
Guagnano MT, Ballone E, Colagrande V, et al. Large waist circumference and risk of hypertension. Int J Obes 2001; 25(9): 1360-4.
[http://dx.doi.org/10.1038/sj.ijo.0801722]
[http://dx.doi.org/10.1038/sj.ijo.0801722]
[84]
Warren TY, Wilcox S, Dowda M, Baruth M. Independent association of waist circumference with hypertension and diabetes in African American women, South Carolina, 2007-2009. Prev Chronic Dis 2012; 9: E105.
[http://dx.doi.org/10.5888/pcd9.110170] [PMID: 22632742]
[http://dx.doi.org/10.5888/pcd9.110170] [PMID: 22632742]
[85]
Levine DA, Calhoun DA, Prineas RJ, Cushman M, Howard VJ, Howard G. Moderate waist circumference and hypertension prevalence: the REGARDS Study. Am J Hypertens 2011; 24(4): 482-8.
[http://dx.doi.org/10.1038/ajh.2010.258] [PMID: 21233800]
[http://dx.doi.org/10.1038/ajh.2010.258] [PMID: 21233800]
[86]
Ren H, Guo Y, Wang D, Kang X, Yuan G. Association of normal-weight central obesity with hypertension: A cross-sectional study from the China health and nutrition survey. BMC Cardiovasc Disord 2023; 23(1): 120.
[http://dx.doi.org/10.1186/s12872-023-03126-w] [PMID: 36890477]
[http://dx.doi.org/10.1186/s12872-023-03126-w] [PMID: 36890477]
[87]
Kuciene R, Dulskiene V. Associations between body mass index, waist circumference, waist-to-height ratio, and high blood pressure among adolescents: A cross-sectional study. Sci Rep 2019; 9(1): 9493.
[http://dx.doi.org/10.1038/s41598-019-45956-9] [PMID: 31263167]
[http://dx.doi.org/10.1038/s41598-019-45956-9] [PMID: 31263167]
[88]
Zhao Y, Zhang M, Luo X, et al. Association of 6-year waist circumference gain and incident hypertension. Heart 2017; 103(17): 1347-52.
[http://dx.doi.org/10.1136/heartjnl-2016-310760] [PMID: 28389523]
[http://dx.doi.org/10.1136/heartjnl-2016-310760] [PMID: 28389523]
[89]
Wang Y, Howard AG, Adair LS, Wang H, Avery CL, Gordon-Larsen P. Waist circumference change is associated with blood pressure change independent of BMI change. Obesity 2020; 28(1): 146-53.
[http://dx.doi.org/10.1002/oby.22638] [PMID: 31755247]
[http://dx.doi.org/10.1002/oby.22638] [PMID: 31755247]
[90]
Niu J, Seo DC. Central obesity and hypertension in Chinese adults: A 12-year longitudinal examination. Prev Med 2014; 62: 113-8.
[http://dx.doi.org/10.1016/j.ypmed.2014.02.012] [PMID: 24552844]
[http://dx.doi.org/10.1016/j.ypmed.2014.02.012] [PMID: 24552844]
