Introduction Raised blood pressure (BP) is a leading cause of premature death in China, but its determinants are not well understood. One likely determinant, adiposity, is increasing rapidly in much of China. We assessed the extent to which differences in BP can be accounted for by differences in body mass index (BMI) and in waist circumference (WC).
Methods We examined cross-sectional data from >510 000 adults aged 30–79 recruited from five rural and five urban areas in China. Height, weight, systolic BP and WC were measured for all participants. Means and associations of SBP with age, BMI and WC were estimated in men and women separately.
Results The population means (SD) of SBP and BMI in men were 132 (20) mm Hg and 23.4 (3.2) kg/m2. Age-adjusted area means of SBP ranged from 126 to 136 mm Hg (F=77 p<0.0001, R2=0.09), and area means of BMI ranged from 22.0 kg/m2 to 25.4 kg/m2. Overall, and within each area, SBP was approximately linearly associated with BMI: overall +17 mm Hg SBP per +10 kg/m2 BMI. However, further adjusting SBP for BMI only accounted for an additional 7% of individual variation in SBP, and had little effect on differences between area means of SBP (F=30 p<0.0001). Despite lower BMI in rural vs urban areas (22.7 vs 24.3 kg/m2), mean SBP was higher in rural areas (132 vs 131 mm Hg, p<0.0001). Similar patterns were found for WC, and in women.
Conclusions SBP is consistently associated with adiposity in individuals, but differences in adiposity do not account for most of the differences in SBP between individuals or between areas.
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