Presentation Information
[14介-口-04]Application of Obesity Indicators in Identifying Hypertension Risk: Evidence from Adults in MacaoAn Analysis Based on the 2020 Physical Fitness Surveillance Data of Macao
*Jiang Lupei1,2, Koya Suzuki2, Xiang Pan1,2, Yibo Gao1,2, Donghai Xu2 (1. Kokumin Tairyoku Monitoring Kagaku Kenshin Kenkyu Center, 2. Supotsu Kenko Kagaku Kenkyuka)
Objective
This study aimed to compare the predictive ability of four obesity indicators (waist circumference [WC], waist-to-height ratio [WHtR], body mass index [BMI], and a body shape index [ABSI]) for hypertension among adults in Macao, and to examine their performance across sex and age groups.
Methods
Data were obtained from the 2020 Physical Fitness Surveillance of Macao. A total of 3,891 adults aged 20-59 years (1,500 males and 2,391 females) were randomly selected from seven districts. Anthropometric measures included height, weight, WC, and body fat percentage. Blood pressure was measured twice, and hypertension was defined as SBP >=140 mmHg, DBP >=90 mmHg, or recent use of antihypertensive drugs. All obesity indices were standardized using Z-scores. Logistic regression was used to assess associations between each index and hypertension. Indicators were also divided into quartiles (Q1-Q4) to evaluate trend risks. Subgroup analyses were conducted by sex and four age groups. ROC curves, AUC, and Youden index were used to evaluate predictive performance.
Results
WHtR, WC, and BMI were significantly associated with hypertension (P<0.001). Z-score regression showed ORs of 1.81 (WHtR), 1.88 (WC), 1.79 (BMI), and 1.24 (ABSI). Quartile analysis revealed increasing risk from Q1 to Q4. Females aged 20-39 were more sensitive to obesity-related hypertension, especially those aged 20-29 (WC OR=2.40, WHtR OR=1.93). In males, peak risk was found in the 40-49 age group (WHtR OR=2.24). WHtR had the highest AUC (0.767 for females, 0.684 for males) and Youden index (0.4519 and 0.3124, respectively).
Conclusion
WHtR was the most effective predictor of hypertension among adults in Macao and is recommended for early screening. Interventions should target young females and middle-aged males. ABSI showed poor performance and is not suitable for hypertension screening. WHtR-based, age- and sex-specific strategies may improve early risk identification and prevention.
This study aimed to compare the predictive ability of four obesity indicators (waist circumference [WC], waist-to-height ratio [WHtR], body mass index [BMI], and a body shape index [ABSI]) for hypertension among adults in Macao, and to examine their performance across sex and age groups.
Methods
Data were obtained from the 2020 Physical Fitness Surveillance of Macao. A total of 3,891 adults aged 20-59 years (1,500 males and 2,391 females) were randomly selected from seven districts. Anthropometric measures included height, weight, WC, and body fat percentage. Blood pressure was measured twice, and hypertension was defined as SBP >=140 mmHg, DBP >=90 mmHg, or recent use of antihypertensive drugs. All obesity indices were standardized using Z-scores. Logistic regression was used to assess associations between each index and hypertension. Indicators were also divided into quartiles (Q1-Q4) to evaluate trend risks. Subgroup analyses were conducted by sex and four age groups. ROC curves, AUC, and Youden index were used to evaluate predictive performance.
Results
WHtR, WC, and BMI were significantly associated with hypertension (P<0.001). Z-score regression showed ORs of 1.81 (WHtR), 1.88 (WC), 1.79 (BMI), and 1.24 (ABSI). Quartile analysis revealed increasing risk from Q1 to Q4. Females aged 20-39 were more sensitive to obesity-related hypertension, especially those aged 20-29 (WC OR=2.40, WHtR OR=1.93). In males, peak risk was found in the 40-49 age group (WHtR OR=2.24). WHtR had the highest AUC (0.767 for females, 0.684 for males) and Youden index (0.4519 and 0.3124, respectively).
Conclusion
WHtR was the most effective predictor of hypertension among adults in Macao and is recommended for early screening. Interventions should target young females and middle-aged males. ABSI showed poor performance and is not suitable for hypertension screening. WHtR-based, age- and sex-specific strategies may improve early risk identification and prevention.
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