Sex differences in the association of abdominal adipose tissue measurements by using quantitative computed tomography (QCT) with untreated hypertension in a Chinese population

Abstract Background: There are inconsistent results regarding the relationships of adiposity anthropometric indices and blood pressure (BP) and hypertension, and whether these relationships differ by sex is unclear. We aimed to elucidate the associations of adiposity indices measured using quantitative computed tomography (QCT) with BP and hypertension and to determine the effect of sex on the relationships in a Chinese population. Methods: Abdominal adipose fat, including visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area, was measured by QCT in 1488 participants. Body mass index (BMI), waist circumference (WC), hip circumference (HC) and systolic (SBP) and diastolic BP (DBP) were measured. Results: Compared to women, men had significantly greater VAT but less SAT regardless of hypertension status. VAT, SAT and WC correlated more with SBP in men than in women. After controlling for body weight, height and age, VAT area and WC in women and VAT area in men were positively associated with SBP and DBP level. VAT area correlated more with the increased risk of hypertension in men than in women [men: odds ratio (OR) = 1.013, women: OR = 1.011]. WC had a significant correlation with an increased risk of hypertension in women but a borderline association in men (P = 0.059) when adjusted for VAT area and SAT area. Conclusions: The association of abdominal adiposity with blood pressure components and hypertension differs qualitatively by sex. WC may be an important determinant of hypertension and may be used for risk stratification for hypertension among Chinese individuals.