Obese women draw the hypertension short straw

By Piriya Mahendra

The associations of obesity with prehypertension and hypertension are stronger in women than men, a study suggests.

The study showed that in men and women, crude and adjusted odds ratios for prehypertension and hypertension in participants with versus participants without high body mass index (BMI) or high waist-to-height ratio were significantly higher than a reference level of 1.00.

However, the odds for having either of the two disorders were significantly higher for women than for men, at 5.54 and 34.58 versus 3.10 and 12.06, respectively).

Area under the receiver operator curve values for the relationships of BMI and waist-to-height ratio with hypertension (excluding those on antihypertensive treatment) were also significantly larger in women than men (0.900 and 0.878 vs 0.831 and 0.818, respectively).

The study involved 28,325 Japanese men and women aged 20-39 years. Hypertension was defined as a systolic blood pressure (SBP) at or above 140 mmHg and/or diastolic blood pressure (DBP) at or above 90 mmHg, and prehypertension as neither a normal blood pressure (SBP <120 mmHg and DBP <80 mmHg) nor hypertension. Obesity was defined as a BMI of 25 kg/m² or more, and a waist-to-height ratio of 0.5 or more.

Author Ichiro Wakabayashi (Hyogo College of Medicine, Japan) says that the mechanisms underlying the stronger relationship between obesity and prehypertension/hypertension in women are unclear, but suggests it may be affected by sympathetic nerve activity.

"This is the first study demonstrating significant gender-specific differences in the degree of association between obesity and blood pressure status," he remarks in the Journal of Hypertension.

"The sex-specific difference in strength of the association between obesity and blood pressure status is thought to be independent of the presence of dyslipidemia and history of therapy for hypertension."

He concludes that although the prevalence of obesity, prehypertension, and hypertension are lower in women than men, both genders should be encouraged to "maintain weight for height in the normal range" to prevent the latter two conditions developing.

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