Trends in obesity abdominal obesity among hypertensive and nonhypertensive adults in the United States

BACKGROUND As the prevalence of obesity has increased in the United States, it is likely that the prevalence of obesity among people with hypertension has increased as well. Because little is known about this issue, our objective was to compare secular trends in the prevalence of obesity and abdominal obesity among hypertensive and nonhypertensive adults in the United States. METHODS We used data from adults aged 18-74 years who participated in National Health and Nutrition Examination Surveys (NHANESs) during 1976-1980, 1988-1994, and 1999-2004. RESULTS Among adults with hypertension, the age-adjusted mean body mass index increased from 27.5 kg/m(2) during 1976-1980 to 31.2 kg/m(2) during 1999-2004 (P < 0.001), and the age-adjusted prevalence of obesity increased from 25.7-50.8% (P < 0.001). Among adults without hypertension, mean body mass index increased from 24.2-27.1 kg/m(2) (P < 0.001), and the prevalence of obesity increased from 8.4-25.1% (P < 0.001). The prevalence of obesity among women with hypertension exceeded that among men with hypertension during all three surveys (P < 0.05 for all three surveys). During 1999-2004, 56.4% (s.e. 3.4) of women with hypertension were obese compared with 46.9% (s.e. 2.1) of men. During this same time period, the prevalence of obesity was highest among Mexican-American women with hypertension (63.8%; s.e. 4.2) and lowest among African-American men with hypertension (43.8%; s.e. 2.5). CONCLUSIONS Over half of people with hypertension are currently obese. The large increase in obesity among people with hypertension presents clinicians with a serious challenge in the management of hypertension.