Obesity and hypertension from a public health perspective in a small remote island of Okinawa, Japan

This study investigated the relationship between obesity and hypertension from a public health perspective in a small remote island of Okinawa where obesity is prevalent. A cross-sectional study was conducted in 456 residents aged =18 years in Yonaguni island who underwent an annual health check-up and the Yonaguni dietary survey in 2022. Each participant responded to our original questionnaire and provided further dietary survey data via the Yonaguni municipal government. The odds ratio for hypertension was calculated in the obese group, using a logistic regression model with the non-obese group serving as the reference. Hypertension was defined as a systolic blood pressure =140 mmHg, a diastolic blood pressure =90 mmHg measured on an automated sphygmomanometer, and/or taking anti-hypertensive agents, while obesity was defined as a body mass index =25 kg/m(2). The proportion of hypertension associated with obesity among all hypertensive subjects was calculated. The prevalence of obesity and hypertension was 54.3% and 49.0% in the 208 male subjects and 32.3% and 43.6% in the 248 female subjects, respectively. The odds ratio for hypertension in the obese group was 3.73 (95% confidence interval, 1.93-7.20) for men and 4.13 (2.06-8.29) for women after adjusting for age, alcohol drinking habit, behavior for lowering salt intake, and smoking habit. Hypertension in 49.5% (95% confidence interval, 29.4%-63.9%) of males and 37.9% (22.6%-50.2%) of females was associated with obesity in this island. Some areas of Japan could be urgently required to address obesity for preventing cardiovascular disease.