Predictors of Hypertension among Adult Tribal Males of India

Abstract

Background: Cardiovascular diseases (CVD) have increased worldwide equally burdening people from different ethnic and socio-economic groups. Hypertension is an eminent modifiable risk factor for CVD and relates to body adiposity, which can be evaluated by various anthropometric measurements. Objective: The present study reports prevalence of under nutrition and hypertension, potential predictors of hypertension and new cutoff values for various disease associated adiposity markers in six tribal populations inhabiting different states in India. Methods: Cross sectional sample of 910 adult males aged 46.98 ±17.17 years was studied. Anthropometric measurement (height, body weight, body circumferences, skinfold thicknesses), blood pressure and socio-demographic characteristics were ascertained. General and regional adiposity indices, muscle diameter and fat % were derived. Descriptive, multivariate regression analyses were performed. Receiver operating characteristics (ROC) was used to determine optimal cutoffs values. Results: Underweight (45.3%) and hypertension [Systolic blood pressure (SBP) - 15.2%, Diastolic blood pressure (DBP)-25.5%] co-exist increasing the morbidity in the tribal population under study. General adiposity measures were better predictors of hypertension. Body mass index (BMI), fat% (negatively associated), age and mid upper arm circumference (positively associated) were independent risk factor for hypertension. Out of all reported cut offs, the new BMI cutoff values (20.12 kg/m2 and 18.98 kg/m2) and for mid upper arm circumference (MUAC) (21.44cm and 21.95cm) for predicting SBP and DBP respectively corresponding nearly to earlier reported standards by World health Organization (WHO). Conclusion: The inverse association of general adiposity markers with blood pressure among the present subjects indicates that CVD is not only prevalent among the affluents but is also affecting the socio-economically and nutritionally deprived groups. Population specific cutoffs for the anthropometric markers are needed to identify individuals with different body compositions at risk. Long term treatment expenses and health burden further depletes the limited economic resources of these vulnerable groups creating a vicious cycle of CVD and under nutrition.