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Year : 2022  |  Volume : 12  |  Issue : 1  |  Page : 28-40

Pre-obesity/obesity in relation to blood pressure among tertiary healthcare workers in an African setting

1 Department of Medicine, Ahmadu Bello University (ABU) Teaching Hospital, Zaria, Nigeria
2 Department of Medicine, University of Maiduguri Teaching Hospital, Borno, Nigeria
3 Department of Medicine, Barau Dikko Teaching Hospital, Kaduna, Nigeria

Correspondence Address:
Dr. Obiageli U Onyemelukwe
Prince Sultan Cardiac Centre, King Fahad Specialist Hospital, Buraidah, Al-Qassim
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajem.ajem_12_22

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Background: The study aimed to determine the predictive power of pre-obesity/obesity indices in pre-hypertension/hypertension among Northern Nigerian tertiary healthcare workers (HCWs). Materials and Methods: A cross-sectional analytical study was done on 348 HCWs. Blood pressure (BP) was defined via the 7th Joint National Committee and the American Heart Association/American College of Cardiology 2017 guidelines. Obesity was defined by body mass index (BMI)/waist circumference (WC). Pearson’s correlation, one-way analysis of variance, and binary logistic regression determined relationships. MedCalc explored the area under the curve (AUC) of obesity indices in hypertension/prehypertension prediction. Results: There were 129 (37.1%) hypertensives out of 348 HCWs. A total of 156 (44.8%) and 114 (32.8%) had systolic and diastolic pre-hypertension, respectively, whereas 241 (60.9%) were pre-obese/obese, of which nurses constituted the majority (82.8%). The anthropometric indices increased from normotension through pre-hypertension to hypertension in females. Pre-obesity [odds ratio (OR): 2.2 (95% confidence interval (CI): 1.1–4.2; P = 0.02)] and generalized obesity [OR: 2.2 (95% CI: 1.2–4.2; P = 0.02)] were associated with hypertension. Central obesity by the International Diabetes Federation (OR: 3.3; 95% CI: 1–11.2; P = 0.005) and World Health Organization (OR: 4.3; 95% CI: 1.1–16.3; P = 0.03) criteria was related to systolic hypertension in males and both systolic/diastolic in females. The optimal WC cut-off values were 87 cm [men: AUC: 0.70 (95% CI: 0.62–0.78); sensitivity (SS): 75%; specificity (SP): 63%; Youden index (YI): 0.36; P = 0.0001] and 101 cm [women: AUC: 0.65 (95% CI: 0.58–0.71); P = 0.0005] for hypertension prediction. The BMI cut-off values for hypertension were 28 kg/m2 [men: AUC: 0.72 (95% CI: 0.64–0.79); YI: 0.36; P = 0.0001] and 31 kg/m2 [women: AUC: 0.63 (95% CI: 0.56–0.69); YI: 0.21; P = 0.0014]. The WC and BMI cut-off values for pre-hypertension prediction were 86 cm (men: AUC: 0.65; SS: 65%; SP: 61%; YI: 0.26; P = 0.0013) and 82 cm (women: AUC: 0.65; SS: 86%; SP: 39%; YI: 0.25; P = 0.0001) and 23 kg/m2(men: AUC: 0.65; P = 0.0001) and 24 kg/m2 (women: AUC: 0.63; P <0.0001). Conclusion: BMI and WC can predict pre-hypertension, with WC being a more reliable predictor of hypertension in Nigerian-African male HCWs. Anthropometric indicators of overall obesity and central obesity can, therefore, be used for screening hypertension/pre-hypertension among Northern-Nigerian HCWs.

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