Body Mass Index, Neck Circumference, and Hypertension: a Prospective Cohort Study

Overview

Journal Front Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2023 Oct 18

PMID 37849941

Authors

Tao-Jun Ren

Kun Zhang

Wen-Juan Li

Shu-Tang Ren

Yun-Zhou Huang

Ning Yang

Shou-Ling Wu

Yu-Ming Li

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to investigate the association between BMI combined with neck circumference and the risk of hypertension.

Methods: We selected participants from the Kailuan study in 2014 who were normotensive as our research subjects. We compared the risk of hypertension among individuals in group 1 (non-obese with low neck circumference), group 2 (non-obese with high neck circumference), group 3 (obese with low neck circumference), and group 4 (obese with high neck circumference).

Results: After a median observation period of 3.86 years, hypertension occurred in 13,383 participants. Subjects in Group 2, 3, and 4 had significantly higher risks of hypertension compared to Group 1, with hazard ratios (HRs) of 1.066 (95% CI: 1.025, 1.110), 1.322 (95% CI: 1.235, 1.415), and 1.422 (95% CI: 1.337, 1.512), respectively. Additionally, adding BMI to a conventional model had a greater incremental effect on predicting hypertension compared to adding neck circumference alone. However, considering both BMI and neck circumference together further improved the prediction of hypertension.

Conclusion: Individuals with both high BMI and high neck circumference face a higher risk of hypertension. Moreover, BMI is a superior predictor of hypertension risk compared to neck circumference, but using both of these measures can further enhance the accuracy of hypertension risk prediction.

Citing Articles

Sex differences in the relationship between body mass index in Chinese adolescents and future risk of hypertension: a decade-long cohort study.

Liu R, Hu H, Cao C, Han Y, Bai Y, Feng W BMC Pediatr. 2025; 25(1):187.

PMID: 40069609 PMC: 11900636. DOI: 10.1186/s12887-025-05555-2.

References

Ben-Noun L, Laor A . Relationship between changes in neck circumference and changes in blood pressure. Am J Hypertens. 2004; 17(5 Pt 1):409-14. DOI: 10.1016/j.amjhyper.2004.02.005. View

Morris L, Kleinberger A, Lee K, Liberatore L, Burschtin O . Rapid risk stratification for obstructive sleep apnea, based on snoring severity and body mass index. Otolaryngol Head Neck Surg. 2008; 139(5):615-8. DOI: 10.1016/j.otohns.2008.08.026. View

Jia G, Sowers J . Hypertension in Diabetes: An Update of Basic Mechanisms and Clinical Disease. Hypertension. 2021; 78(5):1197-1205. PMC: 8516748. DOI: 10.1161/HYPERTENSIONAHA.121.17981. View

Chobanian A, Bakris G, Black H, Cushman W, Green L, Izzo Jr J . Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42(6):1206-52. DOI: 10.1161/01.HYP.0000107251.49515.c2. View

Deng D, Chen C, Wang J, Luo S, Feng Y . Association between triglyceride glucose-body mass index and hypertension in Chinese adults: A cross-sectional study. J Clin Hypertens (Greenwich). 2023; 25(4):370-379. PMC: 10085812. DOI: 10.1111/jch.14652. View

Li Y, Huang Z, Jin C, Xing A, Liu Y, Huangfu C . Longitudinal Change of Perceived Salt Intake and Stroke Risk in a Chinese Population. Stroke. 2018; 49(6):1332-1339. PMC: 6342565. DOI: 10.1161/STROKEAHA.117.020277. View

Yeghiazarians Y, Jneid H, Tietjens J, Redline S, Brown D, El-Sherif N . Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021; 144(3):e56-e67. DOI: 10.1161/CIR.0000000000000988. View

Nielsen S, Guo Z, Johnson C, Hensrud D, Jensen M . Splanchnic lipolysis in human obesity. J Clin Invest. 2004; 113(11):1582-8. PMC: 419492. DOI: 10.1172/JCI21047. View

Hall J, do Carmo J, da Silva A, Wang Z, Hall M . Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015; 116(6):991-1006. PMC: 4363087. DOI: 10.1161/CIRCRESAHA.116.305697. View

10.

Piro S, Spampinato D, Spadaro L, Oliveri C, Purrello F, Rabuazzo A . Direct apoptotic effects of free fatty acids on human endothelial cells. Nutr Metab Cardiovasc Dis. 2007; 18(2):96-104. DOI: 10.1016/j.numecd.2007.01.009. View

11.

Nguyen T, Adair L, He K, Popkin B . Optimal cutoff values for overweight: using body mass index to predict incidence of hypertension in 18- to 65-year-old Chinese adults. J Nutr. 2008; 138(7):1377-82. PMC: 2587351. DOI: 10.1093/jn/138.7.1377. View

12.

Zhou B . Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci. 2002; 15(1):83-96. View

13.

. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021; 398(10304):957-980. PMC: 8446938. DOI: 10.1016/S0140-6736(21)01330-1. View

14.

Wang J, Zhang W, Li Y, Liu L . Hypertension in China: epidemiology and treatment initiatives. Nat Rev Cardiol. 2023; 20(8):531-545. DOI: 10.1038/s41569-022-00829-z. View

15.

Stojiljkovic M, Lopes H, Zhang D, Morrow J, Goodfriend T, Egan B . Increasing plasma fatty acids elevates F2-isoprostanes in humans: implications for the cardiovascular risk factor cluster. J Hypertens. 2002; 20(6):1215-21. DOI: 10.1097/00004872-200206000-00036. View

16.

Heianza Y, Kodama S, Arase Y, Hsieh S, Yoshizawa S, Tsuji H . Role of body mass index history in predicting risk of the development of hypertension in Japanese individuals: Toranomon Hospital Health Management Center Study 18 (TOPICS 18). Hypertension. 2014; 64(2):247-52. DOI: 10.1161/HYPERTENSIONAHA.113.02918. View

17.

Preis S, Massaro J, Hoffmann U, DAgostino Sr R, Levy D, Robins S . Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. J Clin Endocrinol Metab. 2010; 95(8):3701-10. PMC: 2913042. DOI: 10.1210/jc.2009-1779. View

18.

Kawaguchi Y, Fukumoto S, Inaba M, Koyama H, Shoji T, Shoji S . Different impacts of neck circumference and visceral obesity on the severity of obstructive sleep apnea syndrome. Obesity (Silver Spring). 2010; 19(2):276-82. DOI: 10.1038/oby.2010.170. View

19.

Kivimaki M, Batty G, Singh-Manoux A, Ferrie J, Tabak A, Jokela M . Validating the Framingham Hypertension Risk Score: results from the Whitehall II study. Hypertension. 2009; 54(3):496-501. PMC: 2828464. DOI: 10.1161/HYPERTENSIONAHA.109.132373. View

20.

Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z . Status of Hypertension in China: Results From the China Hypertension Survey, 2012-2015. Circulation. 2018; 137(22):2344-2356. DOI: 10.1161/CIRCULATIONAHA.117.032380. View