Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
권호 표지
DOI QR코드

DOI QR Code

Impact of Anthropometric Indices of Obesity on the Risk of Incident Hypertension in Adults with Prehypertension: A Secondary Analysis of a Cohort Study

고혈압 전단계 성인의 비만 인체측정지수가 고혈압 발생 위험에 미치는 영향: 코호트 연구를 활용한 이차분석

  • Jang, Se Young (Department of Nursing, Jeonbuk National University Hospital) ;
  • Kim, Jihun (Department of Nursing, Jeonbuk National University Hospital) ;
  • Kim, Seonhwa (Department of Nursing, Graduate School, Jeonbuk National University) ;
  • Lee, Eun Sun (Department of Nursing, Jeonbuk National University Hospital) ;
  • Choi, Eun Jeong (Department of Nursing, Graduate School, Jeonbuk National University)
  • 장세영 (전북대학교병원 간호부) ;
  • 김지훈 (전북대학교병원 간호부) ;
  • 김선화 (전북대학교 대학원 간호학과) ;
  • 이은선 (전북대학교병원 간호부) ;
  • 최은정 (전북대학교 대학원 간호학과)
  • Received : 2023.05.03
  • Accepted : 2024.01.02
  • Published : 2024.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. Methods: A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox's proportional hazards regression, were conducted using SPSS version 25. Results: Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. Conclusion: The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population.

Keywords

References

  1. Korean Society of Hypertension (KSH). 2022 Hypertension management guidelines: Focused update of the 2018 KSH guideline [Internet]. Korean Society of Hypertension; c2022 [cited 2023 Apr 4]. Available from: https://www.koreanhypertension.org/reference/guide?mode=read&idno=10081.
  2. Korean Society of Hypertension (KSH)-Hypertension Epidemiology Research Working Group. Korea hypertension fact sheet 2022. Clinical hypertension (inpress) [Internet]. Korean Society of Hypertension; c2022 [cited 2023 Apr 4]. Available from: https://www.koreanhypertension.org/reference/guide?mode=read&idno=10079.
  3. Woo GJ, Park SY, Kim YJ, Oh KW. Prevalence and management index of hypertension in Korean adults [Internet]. Korea Disease Control and Prevention Agency; c2021 [cited 2023 Dec 12]. Available from: https://knhanes.kdca.go.kr/knhanes/sub04/sub04_04_02.do.
  4. Centers for Disease Control and Prevention (CDC). About chronic diseases [Internet]. Centers for Disease Control and Prevention; c2022 [cited 2023 Apr 4]. Available from: https://www.cdc.gov/chronicdisease/about/index.htm.
  5. United Nations (UN). Sustainable development goals [Internet]. United Nations [cited 2023 Jan 1]. Available from: https://www.un.org/en/academic-impact/page/sustainable-development-goals.
  6. World Health Organization (WHO). Hypertension [Internet]. World Health Organization; c2023 [cited 2023 Mar 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension.
  7. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-1252. https://doi.org/10.1161/01.HYP.0000107251.49515.c2
  8. Ferguson TS, Younger N, Tulloch-Reid MK, Lawrence-Wright MB, Forrester TE, Cooper RS, et al. Progression from prehypertension to hypertension in a Jamaican cohort: Incident hypertension and its predictors. West Indian Medical Journal. 2010;59(5):486-493.
  9. Korea Disease Control and Prevention Agency (KDCA). Korea health statistics 2019: Korea National Health and Nutrition Examination Survey (KNHANES VIII-1) [Internet]. KDCA; c2020 [cited 2023 Mar 16]. Available from: https://knhanes.kdca.go.kr/knhanes/sub04/sub04_04_01.do.
  10. Chen X, Barywani SB, Hansson PO, Rosengren A, Thunstrom E, Zhong Y, et al. High-normal blood pressure conferred higher risk of cardiovascular disease in a random population sample of 50-year-old men: A 21-year follow-up. Medicine (Baltimore). 2020;99(17):e19895.  https://doi.org/10.1097/MD.0000000000019895
  11. Wang Q, Wang Z, Yao W, Wu X, Huang J, Huang L, et al. Anthropometric indices predict the development of hypertension in normotensive and pre-hypertensive middle-aged women in Tianjin, China: A prospective cohort study. Medical Science Monitor. 2018;24:1871-1879.  https://doi.org/10.12659/msm.908257
  12. Kuwabara M, Hisatome I, Niwa K, Hara S, Roncal-Jimenez CA, Bjornstad P, et al. Uric acid is a strong risk marker for developing hypertension from prehypertension: A 5-year Japanese cohort study. Hypertension. 2018;71(1):78-86. https://doi.org/10.1161/HYPERTENSIONAHA.117.10370
  13. Hadaegh F, Mohebi R, Khalili D, Hasheminia M, Sheikholeslami F, Azizi F. High normal blood pressure is an independent risk factor for cardiovascular disease among middle-aged but not in elderly populations: 9-year results of a population-based study. Journal of Human Hypertension. 2013;27(1):18-23. https://doi.org/10.1038/jhh.2011.112
  14. Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, et al. Blood pressure lowering for prevention of cardiovascular disease and death: A systematic review and meta-analysis. The Lancet. 2016;387(10022):957-967. https://doi.org/10.1016/S0140-6736(15)01225-8
  15. Kim YM, Hong KS, Choi YH, Choi MG, Jeong JY, Lee JM, et al. Rates and related factors of progression to hypertension among prehypertensive local residents aged 45 or over in Chuncheon city: Hallym Aging Study from a community-based cross-sectional study. Korean Circulation Journal. 2008;38(1):43-50. https://doi.org/10.4070/kcj.2008.38.1.43
  16. Shen Y, Chang C, Zhang J, Jiang Y, Ni B, Wang Y. Prevalence and risk factors associated with hypertension and prehypertension in a working population at high altitude in China: A cross-sectional study. Environmental Health and Preventive Medicine. 2017;22(1):19.  https://doi.org/10.1186/s12199-017-0634-7
  17. Kim KY. Risk factors for hypertension in elderly people aged 65 and over, and adults under age 65. Journal of the Korea Academia-Industrial Cooperation Society. 2019;20(1):162-169. https://doi.org/10.5762/KAIS.2019.20.1.162
  18. Venkataraman R, Satish Kumar B, Kumaraswamy M, Singh R, Pandey M, Tripathi P, et al. Smoking, alcohol and hypertension. International Journal of Pharmacy and Pharmaceutical Sciences. 2013;5(4):28-32.
  19. Yoo MG, Park KJ, Kim HJ, Jang HB, Lee HJ, Park SI. Association between alcohol intake and incident hypertension in the Korean population. Alcohol. 2019;77:19-25.  https://doi.org/10.1016/j.alcohol.2018.09.002
  20. Yu ES, Hong K, Chun BC. Incidence and risk factors for progression from prehypertension to hypertension: A 12-year Korean Cohort Study. Journal of Hypertension. 2020;38(9):1755-1762. https://doi.org/10.1097/HJH.0000000000002494
  21. Hu L, Huang X, You C, Li J, Hong K, Li P, et al. Prevalence and risk factors of prehypertension and hypertension in southern China. PLoS One. 2017;12(1):e0170238.  https://doi.org/10.1371/journal.pone.0170238
  22. Maric-Bilkan C, Manigrasso MB. Sex differences in hypertension: Contribution of the renin-angiotensin system. Gender Medicine. 2012;9(4):287-291.  https://doi.org/10.1016/j.genm.2012.06.005
  23. Zheng L, Sun Z, Zhang X, Xu C, Li J, Hu D, et al. Predictors of progression from prehypertension to hypertension among rural Chinese adults: Results from Liaoning Province. European Journal of Cardiovascular Prevention and Rehabilitation. 2010;17(2):217-222.  https://doi.org/10.1097/HJR.0b013e328334f417
  24. Qin P, Chen Q, Wang T, Chen X, Zhao Y, Li Q, et al. Association of 6-year waist-circumference change with progression from prehypertension to hypertension: The Rural Chinese Cohort Study. Journal of Human Hypertension. 2021;35(3):215-225.  https://doi.org/10.1038/s41371-020-0322-8
  25. Igarashi R, Fujihara K, Heianza Y, Ishizawa M, Kodama S, Saito K, et al. Impact of individual components and their combinations within a family history of hypertension on the incidence of hypertension: Toranomon hospital health management center study 22. Medicine (Baltimore). 2016;95(38):e4564.  https://doi.org/10.1097/MD.0000000000004564
  26. Nah EH, Kim HC. Comparison of cardiovascular risk factors between normotension and prehypertension. Korean Journal of Laboratory Medicine. 2007;27(5):377-381.  https://doi.org/10.3343/kjlm.2007.27.5.377
  27. Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: A meta-analysis of randomized controlled trials. Hypertension. 2003;42(5):878-884. https://doi.org/10.1161/01.HYP.0000094221.86888.AE
  28. Kotsis V, Stabouli S, Papakatsika S, Rizos Z, Parati G. Mechanisms of obesity-induced hypertension. Hypertension Research. 2010;33(5):386-393.  https://doi.org/10.1038/hr.2010.9
  29. Korean Society for the Study of Obesity, Committee of Clinical Practice Guidelines. 2022 Clinical practice guidelines for obesity - quick reference guideline [Internet]. Korean Society for the Study of Obesity; c2022 [cited 2023 Apr 29]. Available from: http://general.kosso.or.kr/html/?pmode=BBBS0001300003&smode=view&seq=1383.
  30. de Oliveira CM, Ulbrich AZ, Neves FS, Dias FAL, Horimoto ARVR, Krieger JE, et al. Association between anthropometric indicators of adiposity and hypertension in a Brazilian population: Baependi Heart Study. PLoS One. 2017;12(10):e0185225. https://doi.org/10.1371/journal.pone.0185225
  31. Lee JW, Lim NK, Baek TH, Park SH, Park HY. Anthropometric indices as predictors of hypertension among men and women aged 40-69 years in the Korean population: The Korean Genome and Epidemiology Study. BMC Public Health. 2015;15:140. https://doi.org/10.1186/s12889-015-1471-5
  32. Zhou Z, Hu D, Chen J. Association between obesity indices and blood pressure or hypertension: Which index is the best? Public Health Nutrition. 2009;12(8):1061-1071.  https://doi.org/10.1017/S1368980008003601
  33. Ononamadu CJ, Ezekwesili CN, Onyeukwu OF, Umeoguaju UF, Ezeigwe OC, Ihegboro GO. Comparative analysis of anthropometric indices of obesity as correlates and potential predictors of risk for hypertension and prehypertension in a population in Nigeria. Cardiovascular Journal of Africa. 2017;28(2):92-99. https://doi.org/10.5830/CVJA-2016-061
  34. Park SK, Ryoo JH, Oh CM, Choi JM, Chung PW, Jung JY. Body fat percentage, obesity, and their relation to the incidental risk of hypertension. The Journal of Clinical Hypertension. 2019;21(10):1496-1504.  https://doi.org/10.1111/jch.13667
  35. Eom JS, Lee TR, Park SJ, Ahn Y, Chung YJ. The risk factors of the pre-hypertension and hypertension of rural inhabitants in Chungnam-do. Korean Journal of Nutrition. 2008;41(8):742-753.
  36. Lee SB, Cho AR, Kwon YJ, Jung DH. Body fat change and 8-year incidence of hypertension: Korean Genome and Epidemiology Study. The Journal of Clinical Hypertension. 2019;21(12):1849-1857. https://doi.org/10.1111/jch.13723
  37. Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, et al. 2018 Korean Society for the Study of Obesity guideline for the management of obesity in Korea. Journal of Obesity & Metabolic Syndrome. 2019;28(1):40-45. Erratum in: Journal of Obesity & Metabolic Syndrome. 2019;28(2):143.  https://doi.org/10.7570/jomes.2019.28.1.40
  38. National Institute of Health (NIH). Korean Genome and Epidemiology Study project [Internet]. National Institute of Health; c2012 [cited 2022 Dec 1]. Available from: https://nih.go.kr/ko/main/contents.do?menuNo=300564.
  39. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009;41(4):1149-1160.  https://doi.org/10.3758/BRM.41.4.1149
  40. Jang SY, Ju EY, Choi S, Seo S, Kim DE, Kim DK, et al. Prehypertension and obesity in middle-aged Korean men and women: The third Korea National Health and Nutrition Examination Survey (KNHANES III) study. Journal of Public Health. 2012;34(4):562-569.  https://doi.org/10.1093/pubmed/fds033
  41. Gomez-Ambrosi J, Silva C, Galofre JC, Escalada J, Santos S, Gil MJ, et al. Body adiposity and type 2 diabetes: Increased risk with a high body fat percentage even having a normal BMI. Obesity. 2011;19(7):1439-1444.  https://doi.org/10.1038/oby.2011.36
  42. Lindblad U, Lundholm K, Eckner J, Li Y, Rastam L, Hellgren IM, et al. The 10-year incidence of hypertension across blood pressure categories in a population-based cohort in southwestern Sweden. BMC Cardiovascular Disorders. 2021;21(1):523.  https://doi.org/10.1186/s12872-021-02334-6
  43. Winnicki M, Somers VK, Dorigatti F, Longo D, Santonastaso M, Mos L, et al. Lifestyle, family history and progression of hypertension. Journal of Hypertension. 2006;24(8):1479-1487. https://doi.org/10.1097/01.hjh.0000239281.27938.d4
  44. Korea Health Promotion Institute (KHEPI). Primary Care Chronic Disease Management Program [Internet]. KHEPI; [cited 2023 Dec 31]. Available from: https://www.khepi.or.kr/board?menuId=MENU01065.
  45. Korea Health Promotion Institute (KHEPI). Please tell me about your experience with a healthy city![Internet]. KHEPI; c2023 [cited 2023 Dec 31]. Available from: https://www.khepi.or.kr/board/view?linkId=1005960&menuId=MENU00907.