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(Circulation. 2003;108:1718.)
© 2003 American Heart Association, Inc.

Clinical Investigations

Visceral Adiposity and the Prevalence of Hypertension in Japanese Americans

Tomoshige Hayashi, MD, PhD; Edward J. Boyko, MD, MPH; Donna L. Leonetti, PhD; Marguerite J. McNeely, MD, MPH; Laura Newell-Morris, PhD; Steven E. Kahn, MB, ChB; Wilfred Y. Fujimoto, MD

From the Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System (T.H., E.J.B.), and the Departments of Medicine (T.H., E.J.B., M.J.M., S.E.K., W.Y.F.) and Anthropology (D.L.L., L.N.-M.), University of Washington, Seattle, Wash.

Correspondence to Edward J. Boyko, MD, MPH, Veterans Affairs Puget Sound Health Care System (S-152E), 1660 S Columbian Way, Seattle, WA 98108. E-mail eboyko{at}u.washington.edu

Received December 17, 2002; de novo received May 16, 2003; accepted June 16, 2003.

Abstract

Background— Visceral adiposity is generally considered to play a key role in the metabolic syndrome, including hypertension. The purpose of this study was to evaluate cross-sectionally whether visceral adiposity is associated with prevalence of hypertension independent of other adipose depots and fasting plasma insulin.

Methods and Results— Study subjects included 563 Japanese Americans with normal or impaired glucose tolerance or diabetes but not taking oral hypoglycemic medication or insulin at entry. Variables included plasma glucose and insulin measured after an overnight fast and during an oral glucose tolerance test, and abdominal, thoracic, and thigh fat areas by CT. Total fat area (TFA) was calculated as the sum of these fat areas. Hypertension was defined as having a systolic blood pressure 140 mm Hg, having a diastolic blood pressure 90 mm Hg, or taking antihypertensive medications. Intra-abdominal fat area (IAFA) was associated with a higher prevalence of hypertension. Adjusted odds ratio of hypertension by IAFA was 1.68 for a 1-SD increase (95% CI, 1.20 to 2.37) after adjusting for age, sex, fasting plasma insulin, a nonlinear transformation of 2-hour plasma glucose, and TFA. IAFA remained a significant predictor of prevalence of hypertension even after adjustment for total subcutaneous fat area, abdominal subcutaneous fat area, body mass index, or waist circumference, but no measure of regional or total adiposity was associated with the odds of prevalence of hypertension in models that contained IAFA.

Conclusions— Greater visceral adiposity increases the odds of hypertension in Japanese Americans independent of other adipose depots and fasting plasma insulin.

Key Words: epidemiology • hypertension • visceral fat • obesity • risk factors

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