Relationship between body mass index-to-thigh circumference ratio and incident hypertension among community-dwelling persons.

Background: The incidence of hypertension is increasing worldwide. Recent studies have suggested that smaller thighs are a disadvantage for health and survival, but the association of body mass index (BMI) adjusted for thigh circumference (BMI-to-thigh ratio) and hypertension remains uncertain. Methods: This study included 788 men (mean age 69 ± 10 years) and 975 women (mean age 69 ± 10 years) from a rural village. The relationship between BMI-to-thigh ratio and hypertension was examined using both cross-sectional (baseline, Results: Both the cross-sectional and cohort data demonstrated that higher BMI-to-thigh ratios were associated with an increased prevalence and incidence of hypertension. In the cohort data, participants in the fourth quartile (odds ratios [OR]: 2.58, 95% confidence interval [CI]: 1.15-5.80) and third quartile (OR: 2.54, 95% CI: 1.24-5.20) of the BMI-to-thigh ratio had significantly higher ORs compared with the first quartile. In the cross-sectional data, the optimal BMI-to-thigh ratios cutoff values for predicting hypertension were 51 (sensitivity: 71.1%; specificity: 54.3%) for men and 51 (sensitivity: 65.0%; specificity: 70.6%) for women. In the cohort data, the optimal BMI-to-thigh ratios were 50 (sensitivity: 73.2%; specificity: 52.3%) for men and 47 (sensitivity: 70.9%; specificity: 51.2%) for women. Conclusions: The findings suggest that the BMI-to-thigh ratio is a useful screening tool for incident hypertension.