Cappuccio, Francesco P., Kerry, Sally M., Adeyemo, Adebowale, Luke, Amy, Amoah, Albert G. B., Bovet, Pascal, Connor, Myles D., Forrester, Terrence, Gervasoni, Jean-Pierre, Kaki, Gisela Kimbally, Plange-Rhule , Jacob, Thorogood, Margaret and Cooper, Richard S.. (2008) Body size and blood pressure : an analysis of Africans and the African diaspora. Epidemiology, Vol.19 (No.1). pp. 38-46. ISSN 1044-3983

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Abstract

Background: Blood pressure is directly and causally associated with body mass index (BMI) in populations worldwide. However, the relationship may vary across BMI in populations of African origin.

Methods: We compared the relationship between blood pressure and BMI in populations of African origin, using 13 samples from Africa, the Caribbean, the United Kingdom and the United States. We had access to data from individual participants for age, height, weight, blood pressure, and treatment of hypertension. Analysis was restricted to 18,072 participants (age 35-64 years; 44% men). We carried out multivariate regression analysis to estimate the relationship between blood pressure and BMI by country and by sex. The use of antihypertensive treatment was taken into account by exclusion and by sensitivity analysis.

Results: There was a positive relationship between both systolic and diastolic blood pressure and BMI. In men the slopes for systolic blood pressure varied from 0.27 mm Hg per kg/m2 (95% confidence interval = -0.01 to 0.56) in the United States to 1.72 mm Hg per kg/m2 (95% confidence interval = 0.92 to 2.53) in Ghana (Kumasi). In women, the slopes varied from 0.08 (-0.54 to 0.72) in South Africa to 1.32 (0.98 to 1.66) in the Republic of Congo. Similar variation in trends was seen for diastolic blood pressure. The higher the BMI, the shallower the slopes [-0.10 (-0.15 to -0.06) for systolic, -0.09 (-0.12 to -0.06) for diastolic]. No differences were seen after excluding persons who were being treated for hypertension.

Conclusions: Blood pressure and BMI levels vary among populations of the African diaspora. The effect of BMI on blood pressure levels diminishes as BMI increases. These results suggest a complex relationship among excess body weight, adiposity, and energy expenditure.

Item Type:	Journal Article
Subjects:	D History General and Old World > DT Africa Q Science > QP Physiology R Medicine > R Medicine (General)
Divisions:	Faculty of Medicine > Warwick Medical School > Translational & Systems Medicine > Metabolic and Vascular Health Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Body size -- Africa, Blood pressure -- Africa, African diaspora, African diaspora -- Health aspects
Journal or Publication Title:	Epidemiology
Publisher:	Lippincott Williams & Wilkins
ISSN:	1044-3983
Official Date:	January 2008
Volume:	Vol.19
Number:	No.1
Page Range:	pp. 38-46
Identification Number:	10.1097/EDE.0b013e31815c4d2c
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
URI:	http://wrap.warwick.ac.uk/id/eprint/37433

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