Circunferência da cintura e índice de massa corporal como preditores da hipertensão arterial

Abstract

objective: To evaluate the association between anthropometric indexes -body mass index (BMI) and waist circumference (WC) -and hypertension, and to evaluate the predictive value of these indexes in detecting hypertension. Methods:Cross-sectional population study conducted in the city of Goiânia (GO) with a sample of 1,238 adults aged twenty to 64 years, in 2001. Total obesity was defined as BMI ≥ 30 kg/m 2 ; abdominal obesity was defined as level 2 WC ≥ 88 cm for women and ≥ 102 cm for men, and hypertension was defined as systolic pressure ≥ 140 mmHg, or diastolic pressure ≥ 90 mmHg, or utilization of hypotensive drugs). Multiple logistic regression analysis was used to evaluate the associations between anthropometric indexes and hypertension. The Receiver Operating Characteristic (ROC) curve analysis was used to evaluate sensitivity and specificity of BMI (≥ 30) and level 2 WC as predictive factors of hypertension, and to determine the best predictive cut-off points for hypertension.results: WC was associated with hypertension in both genders. Level 2 WC and BMI ≥30 kg/m 2 showed a low sensitivity in identifying hypertension. The best predictive cut-off points for hypertension coincided with level 1 WC (≥ 80 cm) and with BMI ≥25 kg/m 2 (overweight) for women, and were lower than the values of level 1 WC and of overweight for men.conclusion: Level 2 WC and BMI ≥ 30 kg/m 2 are not adequate to identify the groups at the highest risk of hypertension, since this risk rises with small increases in adiposity.Key words: Waist circumference, body mass index, hypertension, prediction.Obesity is defined as an excess body fat resulting from a chronic imbalance between food intake and energy expenditure 1 . Among the harmful effects of obesity we can point out the fact that it is an independent risk factor for the development of cardiovascular diseases and some types of cancer. Obesity is also strongly associated with other cardiovascular risk factors (hypertension, diabetes, and dyslipidemias), thus increasing cardiovascular morbidity and mortality [1][2][3][4] . For the diagnosis of obesity, there are several indirect methods able to precisely estimate the total amount of body fat as well as its distribution. Among these methods we can point out computed tomography, dual-energy X-ray absorptiometry (DEXA), and magnetic resonance imaging. However, when simplicity and costs of the several methods are considered, the use of anthropometric indexes -body mass index (BMI), waist-hip ratio (WHR), or only waist circumference (WC) and skinfolds (SF) 4 -has been recommended to conduct epidemiological studies.Although BMI does not measure body composition, it is a potentially good indicator of the nutritional status in epidemiological studies. Its utilization is based on results of population studies showing that BMI is weakly correlated with height and strongly correlated with total fat mass, and on the association between high BMI and morbidity and mortality of cardiovascular diseases, diabetes mellitus, colon cancer, and biliar...

Excesso de peso e o risco cardiovascular em jovens seguidos por 17 anos: estudo do Rio de Janeiro

“…Just as important as overweight is the pattern of body fat deposition, specially it central distribution and its relation to the risk for cardiovascular disease 16,17,36 . An important limitation of the anthropometric indexes most widely used in epidemiological studies (BMI, WC and AHR) is the fact that they do not reflect the same fat quantity due to specific characteristics of different populations, like ethnicity 36 …”

“…An important limitation of the anthropometric indexes most widely used in epidemiological studies (BMI, WC and AHR) is the fact that they do not reflect the same fat quantity due to specific characteristics of different populations, like ethnicity 36 …”

Monitoramento por entrevistas telefônicas de fatores de risco para doenças crônicas: experiência de Goiânia, Goiás, Brasil

“…O intervalo de tempo decorrido (3,5 anos) entre os dois estudos explica melhor as diferenças, que seguem a tendência nacional 22 .…”

“…Isto ocorre em grande parte pelo fato de que cerca de 50% dos hipertensos desconhecem sua condição 22 .…”

Physical activity, adiposity and hypertension among patients of public healthcare system

“…Overweight was diagnosed 21 when BMI was ≥ 25 kg/m 2 , and obesity was characterized for values ≥ 30 kg/m 2 . The cutoff points of 1.02 m for men and 0.88 m for women were used to determine abdominal obesity 22 .…”