Presence and Progression of Abdominal Obesity Are Predictors of Future High Blood Pressure and Hypertension

Background General obesity and its progression are major predictors of future hypertension. It has not been established whether abdominal obesity contributes to the development of hypertension. Methods A community-based study population of 2377 normotensive nondiabetic Chinese adults aged ≥30 years were re-examined 10 years after their baseline examination. Results The 10-year cumulative incidence of hypertension was 25.9%. The standardized parameters for the prediction of follow-up systolic blood pressure (BP) for baseline body mass index (BMI), change in BMI, baseline homeostasis model assessment of insulin resistance (HOMA-IR), change in HOMA-IR, baseline waist circumference (WC), and change in WC were 0.19 (P< .001), 0.09 (P< .001), 0.11 (P< .001), 0.08 (P< .001), 0.16 (P< .001), and 0.07 (P< .001), respectively, when age, sex, and baseline systolic BP were accounted for. By stepwise linear regression analysis, age, baseline systolic BP, baseline BMI, change in BMI, baseline WC, and change in WC were significant predictors of the follow-up systolic BP. Both baseline WC and change in WC were significant predictors of follow-up systolic BP or incident hypertension when age, sex, baseline systolic BP, BMI, and change in BMI were accounted for. In a subgroup of younger adults with normal BMI and BP<130/85 mm Hg, baseline systolic BP, change in HOMA-IR, baseline WC, and change in WC were significantly independent predictors of follow-up systolic BP. Conclusion Abdominal obesity and its progression are predictors of future BP and hypertension incidence, independent of the effects of general obesity.