Blood Pressure and Body Mass Index in Lean Rural and Semi-urban Subjects in West Africa

Background: Blood pressure (BP) is positively related to body mass index (BMI) in persons of both Caucasian and African origin, but the precise nature of the relationship is unclear.

Objective: To study the relationship between BP and BMI in a lean African population.

Design: A community-based cross-sectional study.

Methods: The BMI and BP were measured in 362 men and 592 women aged 40-75 years living in Ashanti, Ghana. In total, 498 lived in semi-urban areas and 456 in rural villages.

Results: The BMI was higher among semi-urban women [23.1 kg/m (95% confidence interval (CI), 22.5 to 23.6)] than semi-urban men [20.9 kg/m (95% CI, 20.6 to 21.5)], rural men [19.5 kg/m (95% CI, 19.1 to 19.9)] and rural women [19.9 kg/m (95% CI, 19.5 to 20.3)]. For systolic BP in women older than 52 years and in semi-urban women, the relationship was non-linear. The slope of the line below the change point ("knot") was greater than that above it. There was no evidence of non-linearity in men. For diastolic BP only younger women had a significant "knot" point at 18 kg/m. Again, the slope of the line below the "knot" was greater than that above it. In men, however, there was also evidence of a "knot" in younger and rural men, with the slope of the line below the "knot" being less that that above it (unlike in women).

Conclusions: The relationship between BP and BMI is not linear, and is possibly sigmoid, but this may vary between subgroups.