Association between body mass index and blood pressure across three populations in Africa and Asia.

Despite a growing burden of obesity and hypertension in developing countries, there is limited information on the contribution of body mass index (BMI) to blood pressure (BP) in these populations. This study examines the association between BMI and BP in three populations across Africa and Asia. Data on BMI, BP and other background characteristics of study participants were generated using the World Health Organization STEPwise approach to surveillance (STEPS), at three demographic surveillance sites in Ethiopia, Vietnam and Indonesia. BMI and BP increased along the socioeconomic gradient across the three countries. Mean (s.d.) BMI in men varied between 19.41 (2.28) in Ethiopia to 21.17 (2.86) in Indonesia. A high prevalence of overweight/obesity was noted among Indonesian women (25%) and men (10%), whereas low BMI was widely prevalent in Ethiopia and Vietnam, ranging from 33 to 43%. Mean (s.d.) systolic BP (SBP) among men varied between 117.15 (15.35) in Ethiopia to 127.33 (17.80) in Indonesia. The prevalence of hypertension was highest among women (25%) and men (24%) in Indonesia. Mean BP levels increased with increasing BMI. The risk of hypertension was higher among population groups with overweight and obesity (BMI>/=25 kg/m(2)); odds ratio (95% confidence interval); 2.47 (1.42, 4.29) in Ethiopia, 2.67 (1.75, 4.08) in Vietnam and 7.64 (3.88, 15.0) in Indonesia. BMI was significantly and positively correlated with both SBP and DBP in all the three populations, correlation coefficient (r) ranging between 0.23 and 0.27, P<0.01. High BP exists in a background of undernutrition in populations at early stages of the epidemiologic transition.

Insulinaemia and slight overweight: the case of Vietnamese hypertensives.

OBJECTIVE: To examine the relationship between hypertension, overweight and indices of insulin resistance in Vietnamese subjects. PATIENTS: One hundred and eight hypertensive subjects (51 men and 57 women) over 40 y of age were compared with 36 control subjects over 40 y of age. METHODS: Blood glucose and plasma insulin were measured at fasting and 2 h after 75 g glucose taken orally. RESULTS: Hypertensive subjects had significantly higher body mass index (BMI), triceps skinfold, waist and hip circumferences and waist/hip ratio. Glycaemia at fasting and after glucose were similar in the two groups. Insulinaemia at fasting and after glucose were significantly higher in the hypertensive subjects. In the whole series of hypertensive subjects, plasma insulin and insulin/glucose ratio at fasting and after glucose correlated significantly with BMI, triceps skinfold and waist and hip cicumferences. After exclusion of the subjects with BMI > 22 kg/m2, compared with the controls, plasma insulin and insulin/glucose ratio were significantly higher in the whole hypertensive group and separately in hypertensive men and women. The logistic regression analyses have shown that plasma insulin and insulin/glucose ratio at fasting and after glucose were significantly associated with hypertension, independently of gender, BMI and waist circumference. CONCLUSION: This study shows that in Vietnamese people, essential hypertension is associated with a significant increase in BMI, which however remains far lower than the definition threshold of occidental obesity and with a state of insulin resistance found despite very slight or no excess weight.