Investigating the Performance of Waist Circumference Relative to BMI in Predicting Risk of Obesity and Hypertension among Affluent Indian Adults

In view of the fact that Asians have higher abdominal fat at lower levels of body mass index (BMI),
measures of abdominal adiposity such as waist circumference (WC) and waist to hip ratio (WHR)
were investigated as predictors of hyper-tension. Data on BMI, WC, WHR and blood pressure (BP)
were recorded through a cross-sectional study on 419 urban adults (210 men and 209 women; aged
30 -60 years) in Pune, In-dia. Abdominal obesity was higher among women than men (35.9% vs.
32.4%). However, age adjusted mean systolic BP (124.3 ± 15.1 mmHg vs. 114.7 ± 17.2 mmHg),
diastolic BP (82.9 ± 10.5 mmHg vs. 76.4 ± 10.7 mmHg) and prevalence of hypertension (34.3% vs.
21.5%) was significantly higher (p < 0.01) among men than among women. Although both WC and
WHR increased with in-crease in BMI, correlation co-efficient of BMI with WC was significantly (p <
0.01) higher than that with WHR in both sexes, suggesting that WC could be better for assessing
adiposity. In men, odds ratio [OR (95% CI) = 2.19 (1.08 -4.45)] for hypertension was significant (p <
0.05) only for those in highest tertile of WC while it was significant (p < 0.01) even in the middle tertile
in case of women [8.24 (2.67 -25.43) for higher and 5.71 (1.82 -17.89) for middle tertile]. Optimal
cutoff for identifying obesity and hypertension showed significant (p < 0.01) area under curve (AUC)
and sensitivity for WC than WHR in both sexes. The risk cutoffs were lower compared to those
proposed by the World Health Organization especially for men, but were comparable with reported
Asian studies. Thus, it was evident that WC performed better than BMI and WHR for assessing the
risk of hypertension and may be used as a simple, convenient and inexpensive screening tool in
epidemiological studies.