Anthropometric predictors of hypertension in afro-descendant women
DOI:
https://doi.org/10.15448/1980-6108.2017.3.27527Keywords:
African-Americans, ethnicity and health, abdominal fat, obesity, arterial pressure, ROC curve.Abstract
***Anthropometric predictors of hypertension in afro-descendant women***
AIMS: To determine the association between anthropometric parameters and systemic arterial hypertension and to identify the best anthropometrics predictors of this disease in afro-descendant women from remaining quilombo communities.
METHODS: A cross-sectional study was conducted with quilombola women from Alagoas State. Blood pressure, anthropometric parameters (body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio, conicity index, body fat), sociodemographic variables, smoking and parity were investigated. The associations between anthropometric parameters and systemic arterial hypertension were investigated using Poisson regression with robust variance adjustment. The ability of these parameters to predict the presence of systemic arterial hypertension was analyzed using Receiver Operating Characteristic (ROC) curves.
RESULTS: A total of 1,553 women, aged between 20 and 59 years, were evaluated. The prevalence of systemic arterial hypertension was 35.8% and that of overweight was 48.5%. The presence of systemic arterial hypertension was associated with body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio, and body fat, even after adjusting for age, socioeconomic class, and smoking status. From the ROC curves, the following cutoff points were found: body mass index ≥26.2 kg/m², waist circumference ≥81.6 cm, waist-to-hip ratio ≥0.84, waist-to-height ratio ≥0.54, conicity index ≥1.20 and body fat ≥35.4%. Body fat, waist-to-hip ratio and waist-to-waist ratio were equally able to predict systemic arterial hypertension.
CONCLUSIONS: All indicators of global obesity and those of central obesity, except for the conicity index, were associated with systemic arterial hypertension in this sample of Afro-descendant quilombola women. Percentage of body fat, waist-to-hip ratio and waist-to-height ratio were the best anthropometric predictors of systemic arterial hypertension. These measures had equal, albeit low, discriminatory power for the presence of systemic arterial hypertension in this population.
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References
Susic D, Varagic J. Obesity: a perspective from hypertension. Med Clin North Am. 2017;101:139-57. https://doi.org/10.1016/j.mcna.2016.08.008
Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisa Nacional de Saúde: 2013. Percepção do estado de saúde, estilos de vida e doenças crônicas. Rio de Janeiro: IBGE; 2014.
Pinto AR, Borges JC, Novo MP, Pires PS. Quilombos do Brasil: Segurança Alimentar e Nutricional em territórios titulados. v. 20. Brasília, DF: Ministério do Desenvolvimento Social e Combate à Fome; 2014.
Secretaria de Estado da Cultura (SECULT). Estado de Alagoas. Mapeamento cultural: cultura afro brasileira – comunidades quilombolas [Internet]. Alagoas: SECULT; 2016. [cited 2016 May 20]. Available from: http://www.cultura.al.gov.br/politicas-e-acoes/mapeamento-cultural/cultura-afro-brasileira/comunidades-quilombolas
Soares DA, Barreto SM. Sobrepeso e obesidade abdominal em adultos quilombolas, Bahia, Brasil. Cad Saude Publica. 2014;30(2):341-54. https://doi.org/10.1590/0102-311X00004613
Oliveira SKM, Pereira MM, Guimarães ALS, Caldeira APC. Autopercepção de saúde em quilombolas do norte de Minas Gerais, Brasil. Cien saude colet. 2015;20(9):2879-90. https://doi.org/10.1590/1413-81232015209.20342014
Instituto Brasileiro de Geografia e Estatística (IBGE). Pesquisas de Orçamentos Familiares 2008-2009: Antropometria e Estado Nutricional de Crianças, Adolescentes e Adultos no Brasil. Rio de Janeiro: IBGE; 2010.
Battie CA, Borja-Hart N, Ancheta IB, Flores R, Rao G, Palaniappan L. Comparison of body mass index, waist circumference, and waist to height ratio in the prediction of hypertension and diabetes mellitus: Filipino-American women cardiovascular study. Prev Med Rep. 2016;4:608-13. https://doi.org/10.1016/j.pmedr.2016.10.003
Silva DAS, Petroski EL, Peres MA. Accuracy and measures of association of anthropometric indexes of obesity to identify the presence of hypertension in adults: a population-based study in Southern Brazil. Eur J Nutr. 2013;52:237-46. https://doi.org/10.1007/s00394-012-0314-8
Tuan NT, Adair LS, Stevens J, Popkin BM. Prediction of hypertension by different anthropometric indices in adults: the change in estimate approach Public Health Nutr. 2010;13(5):639-46. https://doi.org/10.1017/S1368980009991479
Saeed AA, Al-Hamdan NA. Anthropometric risk factors and predictors of hypertension among Saudi adult population – A national survey. J Epidemiol and Glob Health. 2013;3:197-204. https://doi.org/10.1016/j.jegh.2013.08.004
Ferreira HS, Silva WO, Santos EA, Bezerra MKA, Silva BCV, Horta BL. Body composition and hypertension: A comparative study involving women from maroon communities and from the general population of Alagoas State, Brazil. Rev Nutr. 2013;26(5):539-49. https://doi.org/10.1590/S1415-52732013000500005
Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Champaign: Human Kinetics Books; 1988.
World Health Organization. WHO Obesity Technical Report Series, 284.Obesity: preventing and managing the global epidemic. Report of a World Health Organization Consultation. Geneva: WHO; 2000.
Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica (ABESO). Diretrizes Brasileiras de Obesidade 2009/2010. 3.ed. São Paulo: AC Farmacêutica; 2009.
Ashwell MS, Hsieh D. Six reasons why the waist‐to‐height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr. 2005;56:303-7. https://doi.org/10.1080/09637480500195066
Pitanga FG, Lessa, I. Sensibilidade e especificidade do índice de conicidade como discriminador do risco coronariano de adultos em Salvador, Brasil. Rev Bras Epidemiol. 2004;7(3):259-69. https://doi.org/10.1590/S1415-790X2004000300004
Durnin JA, Womersley I. Body fat assessed from total body density ad its estimation from skinfold thickness: measurement on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974;32(1):77-97. https://doi.org/10.1079/BJN19740060
Siri WE. Body composition from fluid analysis and density: analysis of methods. In: Brozek J, Henschel A (eds). Techniques for measuring body composition. Washington: National Research Council; 1961.
Sociedade Brasileira de Cardiologia, Sociedade Brasileira de Hipertensão, Sociedade Brasileira de Nefrologia. VI Diretrizes Brasileiras de Hipertensão Arterial. Arq Bras Cardiol. 2010;95(1)(supl.1):1-51.
Sociedade Brasileira de Cardiologia, Sociedade Brasileira de Hipertensão, Sociedade Brasileira de Nefrologia. 7ª Diretriz Brasileira de Hipertensão Arterial. Arq Bras Cardiol. 2016;107(3)(supl.3):1-104.
Associação Brasileira das Empresas de Pesquisa (ABEP). Critério Padrão de Classificação Econômica Brasil. São Paulo: ABEP; 2011.
DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44:837-45. https://doi.org/10.2307/2531595
Hanley JA, Mcneil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982;143(1):29-36. https://doi.org/10.1148/radiology.143.1.7063747
Bezerra VM, Andrade ACS, César CC, Caiaffa WT. Comunidades quilombolas de Vitória da Conquista, Bahia, Brasil: hipertensão arterial e fatores associados. Cad Saude Publica. 2013;29(9):1889-902. https://doi.org/10.1590/S0102-311X2013001300027
Soares DA, Barreto SM. Indicadores nutricionais combinados e fatores associados em população Quilombola no Sudoeste da Bahia, Brasil. Cien Saude Colet. 2015;20(3):821-32. https://doi.org/10.1590/1413-81232015203.03922014
Bezerra VM, Andrade ACS, César CC, Caiaffa WT. Desconhecimento da hipertensão arterial e seus determinantes em quilombolas do sudoeste da Bahia, Brasil. Cien Saude Colet. 2015;20(3):797-807. https://doi.org/10.1590/1413-81232015203.14342014
Cipullo JP, Martin JFV, Ciorlia LAS, Godoy MRP, Cação JC, Loureiro AAC, Cesarino CB, Carvalho AC, Cordeiro JA, Burdmann EA. Prevalência e fatores de risco para hipertensão em uma população urbana brasileira. Arq Bras Cardiol. 2010;94(4):519-26. https://doi.org/10.1590/S0066-782X2010005000014
Buford TW. Hypertension and aging. Ageing Res Rev. 2016;26:96-111. https://doi.org/10.1016/j.arr.2016.01.007
Taylor JY, Chambers AN, Funnell B, Wu CY. Effects of parity on blood pressure among african-american women. J Natl Black Nurses Assoc. 2008;19(2):12-9.
Pimenta AM, Kac G, Gazzinelli A, Corrêa-Oliveira R, Velásquez-Meléndezet G. Associação entre obesidade central, triglicerídeos e hipertensão arterial em uma área rural do Brasil. Arq Bras Cardiol. 2008;90(6):419-25. https://doi.org/10.1590/S0066- 782X2008000600006
Rodrigues SL, Baldo MP, Mill JG. Associação entre a razão cintura-estatura e hipertensão e síndrome metabólica: estudo de base populacional. Arq Bras Cardiol. 2010;95(2):186-91. https://doi.org/10.1590/S0066-782X2010005000073
Huxley R, Barzi F, Lee CMY, Janus E, Lam TH, Caterson I, Lear S, Patel J, Shaw J, Adam J, Oh SW, Kang JH, Zimmet P, Woodward M. Is central obesity a better discriminator of the risk of hypertension than body mass index in ethnically diverse populations? J Hypertens. 2008;26:169-77. https://doi.org/10.1097/HJH.0b013e3282f16ad3
Jiang J, Deng S, Chen Y, Liang S, Ma N, Xu Y, Chen X, Cao X, Song C, Nie W, Wang K. Comparison of visceral and body fat indices and anthropometric measures in relation to untreated hypertension by age and gender among Chinese. Int J Cardiol. 2016;219:204-11. https://doi.org/10.1016/j.ijcard.2016.06.032
Lee JW, Lim NK, Baek TH, Park SH, Park HY. Anthropometric indices as predictors of hypertension among men and women aged 40–69 years in the Korean population: the Korean Genome and Epidemiology Study. BMC Public Health. 2015;15:140. https://doi.org/10.1186/s12889-015-1471-5
Kawamura, T. Interpretação de um teste sob a visão epidemiológica. Eficiência de um teste. Arq Bras Cardiol. 2002;79(4):437-41. https://doi.org/10.1590/S0066-782X2002001300015
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