Relationship of anthropometric indicators with blood pressure levels in rural Wardha.

ABSTRACT

BACKGROUND AND OBJECTIVES: Overweight and obesity are important determinants of health leading to adverse metabolic changes, including increase in blood pressure. Being overweight is associated with two- to six-fold increase in the risk of developing hypertension. Studies in urban Indian population showed strong relationship between different anthropometric indicators and blood pressure levels. Surprisingly, little is known about these relationships in rural population of India. The present study was carried out to examine the relationship between different anthropometric indicators and blood pressure levels in rural population of Wardha district in central India. METHODS: This cross-sectional study was carried out in the areas of two Rural Health Training Centres (RHTC) of Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram; namely Bhidi and Anji through house-to-house visits. Two stage sampling method (30 cluster followed by systematic random) was used to reach the respondents' households. Partial correlation coefficients were used for continuous variables. Linear regression analysis was used to assess the influence of different anthropometric indicators on the systolic and diastolic blood pressure. ROC analysis was done to identify optimal cut-off values while likelihood ratios were calculated to identify the odds of having hypertension in comparison to those with lower values of anthropometric indicators. RESULTS: The mean systolic blood pressures were 120.2 and 118.4 mmHg while the mean diastolic blood pressures were 77.7 and 76.3 mmHg in men and women respectively. There was a significant positive correlation of obesity indicators with both systolic and diastolic blood pressure. For SBP, the correlation coefficient was 0.23 with BMI, 0.23 with waist circumference, 0.11 with WHR and 0.22 with WHtR. For DBP, it was 0.13 with BMI, 0.12 with WC, 0.04 with WHR and 0.11 with WHtR. Step-wise linear regression suggested that BMI and WC were important predictors of hypertension. The suggested cut-off values for BMI were 21.7 for men and 21.2 for women; for waist circumference, the cut-offs were 72.5 for men and 65.5 for women. INTERPRETATION AND CONCLUSION: BMI and WC had strong correlation with systolic and diastolic blood pressure. The suggested lower cut-off values of the anthropometric indicators will cover maximum of the population with higher odds of having hypertension and may help in reducing the mean population blood pressure levels.