BACKGROUND: Hypertension and metabolic syndrome are cardiovascular risk factors associated with increased adiposity. In a previous study, waist-to-stature ratio (WSR) was identified as the best obesity index associated with left ventricular hypertrophy. OBJECTIVE: In this study we compared the ability of this index to identify hypertension and metabolic syndrome with other obesity indexes (body mass index - BMI; waist circumference - WC; and waist-to-hip ratio - WHR) by receiver operating characteristic (ROC) curve analyses. METHODS: 1,655 (45.8% men) participants of the MONICA-WHO/Vitoria Project, mean age 45 ± 11 y were investigated. Metabolic syndrome prevalence (ATP-III criteria) was 32.9%, hypertension was 42.4% and obesity was 19.2%. RESULTS: Regarding the ability to identify hypertension, there was a significant WSR superiority in relation to BMI and WC (p < 0.05) regardless of gender, but WHR (p > 0.05). In relation to the ability to identify metabolic syndrome, there was a significant WSR superiority in relation to WHR in men (p < 0.001), but BMI and WC (p = 0.16 and p = 0.9), respectively. However, in women WSR was significantly superior in relation to WHR (p < 0.001) and BMI (p = 0.025), but WC (p = 0.8). The optimal WSR cutoffs are 0.52 and 0.53 for hypertension and 0.53 and 0.54 for metabolic syndrome, for men and women, respectively. CONCLUSION: Abdominal obesity, identified by WSR as a surrogate, and not overall obesity (BMI as surrogate), is the simplest and best applicable obesity index associated to hypertension and metabolic syndrome in our population.
Hypertension; metabolic syndrome; epidemiologic studies; risk factors; body mass index
