Body Mass Index or Waist-Hip Ratio, Which Correlated With Arterial Stiffness Based on Brachial-Ankle Pulse Wave Velocity in Chinese Rural Adults With Hypertension?

Abstract Background: The aim of this study was to investigate the association betweenbody mass index (BMI), waist-hip ratio (WHR) and arterial stiffness (AS) based on brachial-ankle pulse wave velocity (baPWV) in Chinese rural adults with hypertension.Methods: In this analysis, selected 5,049 Chinese rural adults with hypertension were divided into three groups according to BMI ( <24 kg/m2, control; 24‐28 kg/m2, overweight; and ≥28 kg/m2, obesity), WHR ≥0.9 for male and ≥0.85 for female was defined as central obesity, while baPWV ≥18.0 m/s was considered as increased AS. Multivariate analysis was used to examine the association between BMI, WHR (central obesity) and AS based on baPWV in different models. Furthermore, the generalized additive model and smooth curve fitting was used to visually show the relationship between BMI or WHR with baPWV. Finally, to ensure the robustness between BMI group or central obesity with increased AS, we also did the subgroup analyses that were performed using stratified multivariate regression and interaction analyses and presented in tabulated form or forest plot.Results: The prevalence of overweight, general obesity, central obesity and increased AS were 32.62%, 8.58%, 63.85% and 44.01%, respectively. In comparsion with control group, there are a statistically significant lower prevalence of increased AS in population with overweight or general obesity (adjusted-OR: 0.78, 95% CI 0.65 to 0.92, P <0.001; adjusted-OR: 0.54, 95% CI 0.40 to 0.72, P <0.001, respectively; P for trend <0.001). Whereby in comparsion with non-central obesity group, there are an statistically significant higher prevalence of increased AS in population with central obesity (adjusted-OR: 1.54, 95% CI 1.30 to 1.83, P <0.001). The multivariate analyses indicated that BMI was negatively associated with baPWV (adjusted-β per SD increase: -0.49, 95% CI -0.60 to -0.38, P <0.001). In comparsion with control group, there are an statistically significant inversely relationship between BMI and baPWV in population with overweight or general obesity (adjusted-β: -0.55, 95% CI -0.75 to -0.35, P <0.001; adjusted-β: -1.00, 95% CI -1.32 to -0.67, P <0.001, respectively; P for trend <0.001). On the contrary, WHR was positively associated with baPWV (adjusted-β per SD increase: 0.27, 95% CI 0.17 to 0.38, P <0.001). In comparsion with non-central obesity group, there are a statistically significant positively relationship between WHR and baPWV in population with central obesity (adjusted-β: 0.55, 95% CI 0.34 to 0.75, P <0.001).Conclusion: We found that there was an inversely relationship between BMI and baPWV or increased AS, whereas WHR or central obesity is positively associated with baPWV and increased AS in Chinese rural adults with hypertension.