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This Article Full Text (Publish Ahead of Print[PDF]) All Versions of this Article: 89/6/1905    most recent ajcn.2008.26809v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tuan, N. T Articles by Popkin, B. M Search for Related Content PubMed PubMed Citation Articles by Tuan, N. T Articles by Popkin, B. M Agricola Articles by Tuan, N. T Articles by Popkin, B. M

The association between body mass index and hypertension is different between East and Southeast Asians^1,2,3

¹ From the Department of Nutrition (NTT, LSA, KH, and BMP), Department of Epidemiology (KH), Department of Biostatistics (CMS), and Carolina Population Center (NTT, LSA, CMS, and BMP), University of North Carolina at Chapel Hill, NC.

² Supported by The Vietnam Educational Foundation and NIH grants R01-HD30880, DK056350, and R01-HD38700.

³ Reprints not available. Address correspondence to BM Popkin, Carolina Population Center, University of North Carolina, 123 West Franklin Street, Chapel Hill, NC 27516-3997. E-mail: popkin{at}unc.edu.

ABSTRACT

Background: Few studies have allowed direct comparison of the association between body mass index (BMI; in kg/m²) and hypertension in different Asian ethnicities.

Objective: We compared the association of BMI with hypertension in Chinese, Indonesian, and Vietnamese adults and determined BMI cutoffs that best predicted hypertension in these populations.

Design: We included 7562 Chinese, 18,502 Indonesian, and 77,758 Vietnamese participants aged 18–65 y. Blood pressure, weight, and height were measured by trained health workers. To define an optimal BMI cutoff, we computed and searched for the shortest distance on receiver operating characteristic curves.

Results: Despite a low mean BMI, the prevalences of hypertension in Chinese, Indonesian, and Vietnamese men were 22.9%, 24.8%, and 14.4% and in women were 16.6%, 26.9%, and 11.7%, respectively. At all BMI levels, the sex-specific prevalence of hypertension was higher in Indonesian adults than in Chinese and Vietnamese adults (P < 0.05 at almost all BMI levels). The overall and stratified analyses suggested optimal BMI cutoffs of 23–24, 21–22.5, and 20.5–21 for Chinese, Indonesian, and Vietnamese adults, respectively. The cutoffs were 0.5–1.0 units higher in women than in men and in the older (41–65 y) than in the younger (18–40 y) participants.

Conclusions: The study showed an ethnic difference in the BMI-hypertension association and in optimal BMI cutoffs between Chinese, Indonesian, and Vietnamese adults. Country-specific or even country-, sex-, and age-specific BMI cutoffs might be needed to identify persons at high risk of cardiovascular diseases.

Received for publication August 8, 2008. Accepted for publication March 17, 2009.