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Anthropometric measures change and incidence of high blood pressure levels among adults: a population-based prospective study in Southern Brazil

Silva, Rebeca Cipriano Braga; Silva, Diego Augusto da; Bastos, João Luiz Dornelles; Peres, Karen Glazer; Peres, Marco; González-Chica, David Alejandro

doi: 10.1097/HJH.0000000000001128

Objective: The objective was to evaluate the effects of BMI and waist circumference change on the cumulative incidence of high blood pressure levels (HBP) among adults.

Methods: Prospective longitudinal study in Southern Brazil, with a sample evaluated in 2009 (n = 1720) and 2012 (n = 1213). The incidence of HBP was estimated using measured values of systolic and diastolic arterial pressure (≥140/90 mmHg).

Results: The prevalence of overweight (BMI ≥ 25 kg/m2) was 47.3% in 2009 and 55.0% in 2012. The incidence of HBP was 32.0%. Being overweight or having an elevated waist circumference (top quartile) in the two waves increased the incidence of HBP [odds ratio 3.41 (95% confidence interval (CI) 2.10; 5.53) and 5.42 (95% CI 2.65; 11.08), respectively] compared with those always eutrophic. Being overweight in either wave also increased the risk of HBP, whereas reducing waist circumference was a protective factor. When the annual BMI and waist circumference change were evaluated (conditional to the baseline measurements, age, and sex) the adjusted predicted incidence of HBP was 46.5% (95% CI 36.9; 56.1) among individuals with an annual BMI change more than +1.0 kg/m2, and 45.1% (95% CI 36.7; 53.4) among those with an annual waist circumference change more than +3.0 cm. Among those who reduced their BMI and waist circumference, the incidence of HBP were 25.9 and 23.8%, respectively.

Conclusion: Being overweight (in any wave), maintaining an elevated waist circumference, or having an annual rise of these measurements above the expected values, all increased the incidence of HBP. Reducing the waist circumference showed greater benefits for the prevention of HBP than BMI changes.

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aPostgraduate Program in Nutrition

bPostgraduate Program in Public Health, Federal University of Santa Catarina, Brazil

cAustralian Research Centre for Population Oral Health

dDiscipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, University of Adelaide, Adelaide, Australia

Correspondence to David Alejandro González-Chica, PhD, Discipline of General Practice, Adelaide Medical School, University of Adelaide, 178 North Terrace, Level 11, MDP DX 650 550. Adelaide 5005, South Australia, Australia. Tel: +61 8 8313 1631; e-mail:

Abbreviations: BIC, Bayesian information criteria; BP, blood pressure; CI, confidence interval; HBP, high blood pressure; NCD, noncommunicable chronic disease; OR, odds ratio

Received 4 July, 2016

Revised 18 August, 2016

Accepted 31 August, 2016

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