Body fat percentage, obesity, and their relation to the incidental risk of hypertension

Abstract

Studies have indicated that increased body fat is associated with cardiovascular risk factors including hypertension. However, there is only limited information about the influence of body fat percentage (BF%) on incident hypertension. In a cohort of Korean genome epidemiology study (KoGES), 4864 non‐hypertensive participants were divided into 5 quintile groups, and followed‐up for 10 years to monitor incident hypertension. Cox proportional hazard model was used to evaluate the hazard ratio (HRs) and 95% confidence interval (CI) for hypertension (adjusted HRs [95% CI]) according to BF% quintile groups. Subgroup analysis was conducted by low or high level of BF% (cutoff: 22.5% in men and 32.5% in women) and low or high level of body mass index (BMI), waist circumference (WC) and waist‐to‐hip ratio (WHR). In adjusted model, compared with BF% quintile 1, the risk of incident hypertension significantly increased over BF% quintile 3 (BF% ≥19.9%) in men (quintile 3:1.42 [1.10‐1.85], quintile 4:1.58 [1.22‐2.05], quintile 5:1.82 [1.40‐2.36]), and quintile 4 (BF% ≥32.5%) in women (quintile 4:1.48 [1.12‐1.94], quintile 5:1.56 [1.20‐2.04]). Subgroup analysis showed that individuals with high BF% were significantly associated with the increased risk of hypertension even in individuals with low BMI, WC, and WHR. The risk of hypertension increased proportionally to BF% over the specific level of BF% in Koreans. Even in non‐obese individuals, increase in BF% was significantly associated with the increased risk of hypertension.

Prognostic value of adiposity indices for hypertension

“…The study by Park et al validates previously reported information on the importance of measuring BF% even in non‐obese individuals to detect those who have an increased risk of developing hypertension, in a Korean population. The confirmation of this association should be a point of interest for considering its implementation in routine clinical practice and to be taken into account in future guidelines.…”

“…One of the main points of the study by Park et al is the long follow‐up period, ie, 10 years, but also the finding that high BF% was significantly associated with the increased risk of incident hypertension even in individuals with low BMI, WC, and WHR. This underlies the importance of globally assess adiposity in general population, independently of “apparent” normal weight.…”

“…What is not known so well is the role of obesity as a predictor of incident hypertension. In the manuscript by Park et al it is shown that body fat percentage (BF %), as a marker of obesity, is associated with the increased risk of hypertension in a cohort of Korean non‐hypertensive subjects. This association occurs even in non‐obese individuals, with low body mass index (BMI), waist circumference (WC), and waist to hip ratio (WHR).…”

The Association of Body Fat Percentage With Hypertension in a Chinese Rural Population: The Henan Rural Cohort Study

“…Early identification and control of individuals suffered from hypertension were, therefore, critical for improving the quality of life and reducing mortality in a high-risk population. Body fat percentage (BFP), as a more accurate and reliable indicator for evaluating general obesity compared to BMI, cannot be neglected (11,12). Briefly, a previous study performed in southern Brazil showed that compared to individuals with lower BFP, individuals who were with higher BFP were prone to have a greater risk of hypertension (13).…”

“…Moreover, Jiang et al also reported that BFP was a better indicator for discriminating hypertension, regardless of gender (14). Recently, research conducted in South Korea indicated that increased BFP was associated with the high risk of hypertension even in non-obese subjects (12). However, Alvin Chandra et al found that neither total nor subcutaneous adiposity was related to the onset of hypertension (15).…”