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Ann Intern Med. 2004 Jun 15;140(12):992-1000.

Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans.

Author information

1
Veterans Affairs Puget Sound Health Care System and the University of Washington, Seattle, Washington 98108, USA.

Abstract

BACKGROUND:

Visceral adiposity is generally considered to play a key role in the metabolic syndrome.

OBJECTIVE:

To examine the relationship between directly measured visceral adiposity and the risk for incident hypertension, independent of other adipose depots and fasting plasma insulin levels.

DESIGN:

Community-based prospective cohort study with 10- to 11-year follow-up.

SETTING:

King County, Washington.

PARTICIPANTS:

300 Japanese Americans with a systolic blood pressure less than 140 mm Hg and a diastolic blood pressure less than 90 mm Hg who were not taking antihypertensive medications, oral hypoglycemic medications, or insulin at study entry.

MEASUREMENTS:

Abdominal, thoracic, and thigh fat areas were measured by using computed tomography. Total subcutaneous fat area was calculated as the sum of these fat areas excluding the intra-abdominal fat area. Hypertension during follow-up was defined as having a systolic blood pressure of 140 mm Hg or greater, having a diastolic blood pressure of 90 mm Hg or greater, or taking antihypertensive medications.

RESULTS:

There were 92 incident cases of hypertension during the follow-up period. The intra-abdominal fat area was associated with an increased risk for hypertension. Multiple-adjusted odds ratios of hypertension for quartiles of intra-abdominal fat area (1 = lowest; 4 = highest) were 5.07 (95% CI, 1.75 to 14.73) for quartile 3 and 3.48 (CI, 1.01 to 11.99) for quartile 4 compared with quartile 1 after adjustment for age, sex, fasting plasma insulin level, 2-hour plasma glucose level, body mass index, systolic blood pressure, alcohol consumption, smoking status, and energy expenditure through exercise (P = 0.003 for quadratic trend). The intra-abdominal fat area remained a significant risk factor for hypertension, even after adjustment for total subcutaneous fat area, abdominal subcutaneous fat area, or waist circumference; however, no measure of these fat areas was associated with risk for hypertension in models that contained the intra-abdominal fat area.

LIMITATIONS:

It is not known whether these results pertain to other ethnic groups.

CONCLUSIONS:

Greater visceral adiposity increases the risk for hypertension in Japanese Americans.

[Indexed for MEDLINE]

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