Association between hypertension and anthropometric indices in adult men: a case control study

Sharad B. Mankar, Santosh L. Wakode, Sonal Deshpande, Naina S. Wakode, Manoj T. Jiwtode, Neelam V. Mishra


Background: Controversies over the value of BMI for the estimation of body fat have led to recommendations of the use of new methods to measure body fat. The objective of the study was to find the association between hypertension and anthropometric variables like BMI, Waist-Hip ratio, Ponderal index, Brocca index.

Methods: Newly diagnosed 150 hypertensive patients aged more than 30 years attending medicine OPD were selected as cases. Equal numbers of age matched controls were selected from relative or neighbourhood. Blood pressure of the subjects was recorded. BMI, WHR, Ponderal index, Brocca index were calculated. Association between two categorical variables was analyzed by using Chi -square test, odds ratio along with 95% confidence interval (CI). Student’s T test was used as test of significance for difference between two means. P<0.05 was considered to be statistically significant.

Results: Those having BMI >25 has 2.28 (1.31, 3.95) times risk of being hypertensive. Those having waist to hip ratio (WHR) >0.9 had 2.73 (1.68, 4.41) times higher chance of being hypertensive. Those having Ponderal Index <40 had 3.08 (1.75, 5.42) times higher risk of hypertension. Those with ideal body weight percent more than 100 by Brocca index had 2.98 (1.84, 4.83) times chance of getting hypertension.

Conclusions: Ponderal index (PI), Ideal body weight percent by Brocca index (BI) and waist hip ratio (WHR) were found to be strongly associated with hypertension with higher odds ratio than BMI.


Hypertension, BMI, WHR, Ponderal index, Brocca index

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Malhotra S, Bala R. Hypertension. Plant Horti Tech. 2005;6(1):49-55.

The Asia-Pacific perspective. Redefining obesity and its treatment. Sydney: Health Communication 2000. Available from: nutrition/documents/docs/Redefiningobesity.pdf. Accessed on 21 March 2014.

Seidell JC, Kahn HS, Williamson DF, Lissner L, Valdez R. Report from a Centers of Disease Control and Prevention workshop on use of adult anthropometry for public health and primary health care. Am J Clin Nutr. 2001;73:123–6.

Wei M, Gaskill SP, Haffner SM, Stern MP. Waist circumference as the best predictor of non insulin dependent diabetes mellitus (NIDDM) compared to body mass index, waist/hip ratio and other anthropometric measurements in Mexican Americans: a 7- year prospective study. Obes Res. 1997;5:16-23.

Isomaa B, Almgren P, Tuomi T. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24:683–9.

Yusuf S, Hawken S, Ounpuu S. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005;366(9497):1640–9.

Han TS, Sattar N, Lean M. Assessment of obesity and its clinical implications. BMJ. 2006;333:695-8.

Park SH, Choi SJ, Lee KS, Park HY. Waist circumference and waist to height ratio as predictors of cardiovascular disease risk in Korean adults. Circulation J. 2009;73(9):1643–50.

Ko KP, Oh DK, Min H. Prospective study of optimal obesity index cutoffs for predicting development of multiple metabolic risk factors: the Korean genome and epidemiology study. J Epidemiol. 2012;22:433–9.

Tambe DB, Phadke AV, Kharche JS, Joshi AR. Correlation of blood pressure with Body Mass Index (BMI) and Waist to Hip Ratio (WHR) in middle aged men. Int J Med Update. 2010;5(2):26-30.

Cox BD, Whichelow MJ, Ashwell M, Presvost AT, Lejeune SR. Association of anthropometric indices with elevated blood pressure in British adults. Int J Obesity Related Metabolic Dis. 1997;21(8):674-80.

Brown CD, Hiqqins M, Donato KA, Rohde FC, Garrison R, Obarzanek E et al. Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000;8(9):605-19.

Harris MM, Stevens J, Thomas N, Schreiner P, Folsom AR. Associations of Fat Distribution and Obesity with Hypertension in a Bi-ethnic Population: The ARIC Study. Obesity Res. 2000;8(7):516-24.

Mungreiphy NK, Kapoor S and Sinha R. Association between BMI, Blood Pressure, and Age: Study among Tangkhul Naga Tribal Males of Northeast India. Journal of Anthropology. 2011, doi:10.1155/2011/748147.

Dua S, Bhuker M, Sharma P, Dhall M, Kapoor S. Body Mass Index Relates to Blood Pressure Among Adults. N Am J Med Sci 2014;6(2):89-95.

Kalani Z, Salimi T, Rafiei M. Comparison of obesity indexes BMI, WHR and WC in association with Hypertension: results from a Blood Pressure Status Survey in Iran. J Cardiovascular Dis Res. 2015;6(2):72-7.

Kodali V, Tripuraribhatla PK, RaghuRam TC, Kodavanti MR, Eswaran P, Krishnaswamy K. Abdominal adiposity and metabolic alterations in hypertension – a case control study. Asia Pacific J Clin Nutr. 1997;6(3):180-5.

Reddy KSN, Reddy KK, Sudha G. Overall and Abdominal Adiposity on Blood Pressure: Consistency and Evaluation of their Association in an Adult Indian Population. J Life Sci. 2010;2(2):117-25.

DiPietro L, Ostfeld AM, Rosner GL. Adiposity and Stroke among Older Adults of low socioeconomic status: The Chicago stroke study. Am J Public Health. 1994;84(1):14-9.

Rausher H, Popp W, Vollmann A, Ritschka L, Zwick H. Obstructive sleep apnea – a risk factor for arterial hypertension. Wien Klin Wochenschr. 1989;101(6):200-3.

Guagnano MT, Cugini P, Merlitti D, Murri R, Palitti VP, Pilloti R and Sensi S. Association of body mass index and regional fat distribution with blood pressure investigated by 24-hour ambulatory blood pressure monitoring in android type obese. Chronobiol Int. 1995;12(1):46-54.

Guagnano MT, Ballone E, Colagrande V, Vecchia RD, Manigrasso MR, Merlitti D, Riccioni G and Sensi S. Large waist circumference and risk of hypertension. Int J Obesity. 2001;25(9):1360-4.

Dalton M, Cameron AJ, Zimmet PZ, Shaw JE, Jolley D, Dunstan DW & Welborn TA. J Internal Med. 2003;254:555–63.