Independent impact of obesity and fat distribution in hypertension prevalence and control in the elderly

Background Studies on the impact of weight excess and fat distribution on blood pressure are usually limited to young and middle-aged population, and data on the elderly are scarce. Methods and results We performed an analysis of the Prevencion de Riesgo de Ictus, a population-based study on individuals aged 60 years or more in Spain, to assess the impact of weight excess, stratified by body mass index (normal < 25; overweight 25-29.9; obesity >= 30 kg/m(2)), and waist circumference [ increased if >= 88cm (women) or >= 102 (men)] on the prevalence on hypertension and lack of blood pressure control. In 6263 individuals (mean age 71.9 years old, 53.3% women; 73.0% with diagnosed hypertension), prevalence of obesity was 35.0%, and 65.6% showed an increased waist circumference. Body mass index and waist circumference showed an independent impact on the prevalence and absence of hypertension control. In a multivariate model including age, sex, body mass index, and waist circumference, prevalence of hypertension was higher in the overweight and obesity groups (odds ratio 1.41 and 1.96, respectively, compared to normal weight), and in those with increased waist circumference (odds ratio 1.25) compared with normal waist circumference. After further adjustment for antihypertensive therapy, overweight, and obesity (odds ratio 1.40 and 1.59, respectively) as well as increased waist circumference (odds ratio 1.39) were independently related to absence of blood pressure control. The impact of waist circumference on hypertension and blood pressure control was shown in each category of body mass index. Conclusion In this cross-sectional study in an elderly population, body mass index and waist circumference showed an independent and direct impact on the prevalence of hypertension and on the absence of blood pressure control.