Patterns of general and abdominal obesity and their association with hypertension control in the iranian hypertensive population: insights from a nationwide study

Abstract Background The coexistence of obesity and hypertension (HTN) is a global health concern due to its association with various health abnormalities. This study targeted the association between uncontrolled HTN—defined according to the JNC8 guidelines— and different obesity patterns (general an...

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Main Authors: Fataneh Esmaeili, Keyvan Karimi, Samaneh Akbarpour, Mohammadreza Naderian, Shirin Djalalinia, Ozra Tabatabaei-Malazy, Ali Golestani, Nazila Rezaei
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-024-21264-4
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author Fataneh Esmaeili
Keyvan Karimi
Samaneh Akbarpour
Mohammadreza Naderian
Shirin Djalalinia
Ozra Tabatabaei-Malazy
Ali Golestani
Nazila Rezaei
author_facet Fataneh Esmaeili
Keyvan Karimi
Samaneh Akbarpour
Mohammadreza Naderian
Shirin Djalalinia
Ozra Tabatabaei-Malazy
Ali Golestani
Nazila Rezaei
author_sort Fataneh Esmaeili
collection DOAJ
description Abstract Background The coexistence of obesity and hypertension (HTN) is a global health concern due to its association with various health abnormalities. This study targeted the association between uncontrolled HTN—defined according to the JNC8 guidelines— and different obesity patterns (general and abdominal) among adult hypertensive individuals. Methods Data for the present investigation were obtained from the 2021 STEPwise Approach to NCD Risk Factor Surveillance (STEPS) national survey in Iran. Participants were classified based on general obesity (BMI) and different abdominal obesity patterns (waist circumference [WC], waist-to-hip ratio [WHR], and waist-to-height ratio [WHtR]). Data were weighted by sex, age, and residence (rural and urban). Multivariate logistic regression models were performed to determine the association between different obesity patterns and uncontrolled HTN, adjusting for confounders including demographic variables, lifestyle factors, and history of metabolic abnormalities. Results A total of 8,692 hypertensive adult subjects ≥ 18 years were recruited from all provinces in Iran. The overall mean age of participants was 55.8 ± 0.15, and 55.6% being women. The prevalence of general obesity among controlled and uncontrolled hypertensive patients was 30.3% and 69.8%, respectively. Regarding abdominal obesity, the prevalence among controlled and uncontrolled hypertensive patients was 29.8% and 70.2% based on WC, 28.4% and 71.6% based on WHR, and 28.8% and 71.2% based on WHtR, respectively. Compared to normal weight, underweight (adjusted odds ratio [AOR] = 0.94, 95% CI: 0.57–1.56), overweight (1.37 [1.16–1.61]), and general obesity (1.47 [1.24–1.75]) were associated to uncontrolled HTN compared to normal weight. Abdominal obesity according to WC (1.30 [1.13–1.51]), WHR (1.31 [1.10–1.53]), and WHtR (1.39 [1.11–1.74]) was also associated with uncontrolled HTN. Conclusion Both general and abdominal obesity are more prevalent and strongly associated with uncontrolled HTN in hypertensive patients. These findings underscore the need for healthcare providers to implement targeted interventions promoting healthy lifestyle changes to mitigate these risk factors and improve HTN management.
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spelling doaj-art-9b47728fcc964b4db96c4b5379ec05632025-01-26T12:55:49ZengBMCBMC Public Health1471-24582025-01-0125111310.1186/s12889-024-21264-4Patterns of general and abdominal obesity and their association with hypertension control in the iranian hypertensive population: insights from a nationwide studyFataneh Esmaeili0Keyvan Karimi1Samaneh Akbarpour2Mohammadreza Naderian3Shirin Djalalinia4Ozra Tabatabaei-Malazy5Ali Golestani6Nazila Rezaei7Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesDeputy of Research & Technology, Ministry of Health & Medical EducationNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesEndocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical SciencesNon-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesAbstract Background The coexistence of obesity and hypertension (HTN) is a global health concern due to its association with various health abnormalities. This study targeted the association between uncontrolled HTN—defined according to the JNC8 guidelines— and different obesity patterns (general and abdominal) among adult hypertensive individuals. Methods Data for the present investigation were obtained from the 2021 STEPwise Approach to NCD Risk Factor Surveillance (STEPS) national survey in Iran. Participants were classified based on general obesity (BMI) and different abdominal obesity patterns (waist circumference [WC], waist-to-hip ratio [WHR], and waist-to-height ratio [WHtR]). Data were weighted by sex, age, and residence (rural and urban). Multivariate logistic regression models were performed to determine the association between different obesity patterns and uncontrolled HTN, adjusting for confounders including demographic variables, lifestyle factors, and history of metabolic abnormalities. Results A total of 8,692 hypertensive adult subjects ≥ 18 years were recruited from all provinces in Iran. The overall mean age of participants was 55.8 ± 0.15, and 55.6% being women. The prevalence of general obesity among controlled and uncontrolled hypertensive patients was 30.3% and 69.8%, respectively. Regarding abdominal obesity, the prevalence among controlled and uncontrolled hypertensive patients was 29.8% and 70.2% based on WC, 28.4% and 71.6% based on WHR, and 28.8% and 71.2% based on WHtR, respectively. Compared to normal weight, underweight (adjusted odds ratio [AOR] = 0.94, 95% CI: 0.57–1.56), overweight (1.37 [1.16–1.61]), and general obesity (1.47 [1.24–1.75]) were associated to uncontrolled HTN compared to normal weight. Abdominal obesity according to WC (1.30 [1.13–1.51]), WHR (1.31 [1.10–1.53]), and WHtR (1.39 [1.11–1.74]) was also associated with uncontrolled HTN. Conclusion Both general and abdominal obesity are more prevalent and strongly associated with uncontrolled HTN in hypertensive patients. These findings underscore the need for healthcare providers to implement targeted interventions promoting healthy lifestyle changes to mitigate these risk factors and improve HTN management.https://doi.org/10.1186/s12889-024-21264-4ObesityHigh blood pressureUncontrolled hypertensionAbdominal obesitiesSTEPS surveyIran
spellingShingle Fataneh Esmaeili
Keyvan Karimi
Samaneh Akbarpour
Mohammadreza Naderian
Shirin Djalalinia
Ozra Tabatabaei-Malazy
Ali Golestani
Nazila Rezaei
Patterns of general and abdominal obesity and their association with hypertension control in the iranian hypertensive population: insights from a nationwide study
BMC Public Health
Obesity
High blood pressure
Uncontrolled hypertension
Abdominal obesities
STEPS survey
Iran
title Patterns of general and abdominal obesity and their association with hypertension control in the iranian hypertensive population: insights from a nationwide study
title_full Patterns of general and abdominal obesity and their association with hypertension control in the iranian hypertensive population: insights from a nationwide study
title_fullStr Patterns of general and abdominal obesity and their association with hypertension control in the iranian hypertensive population: insights from a nationwide study
title_full_unstemmed Patterns of general and abdominal obesity and their association with hypertension control in the iranian hypertensive population: insights from a nationwide study
title_short Patterns of general and abdominal obesity and their association with hypertension control in the iranian hypertensive population: insights from a nationwide study
title_sort patterns of general and abdominal obesity and their association with hypertension control in the iranian hypertensive population insights from a nationwide study
topic Obesity
High blood pressure
Uncontrolled hypertension
Abdominal obesities
STEPS survey
Iran
url https://doi.org/10.1186/s12889-024-21264-4
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