The SA Journal Diabetes & Vascular Disease Vol 16 No 1 (July 2019)

SA JOURNAL OF DIABETES & VASCULAR DISEASE

RESEARCH ARTICLE

VOLUME 16 NUMBER 1 • JULY 2019

pressure could be influenced by both biological and behavioural

risks.

Biological factors include chromosome differences and

sex hormones, which serve as a mechanism of protection against

hypertension in most young women until they reach menopause.

In contrast to our study, Luz

et al

reported the prevalence of

hypertension to be 54.6 and 71.3% inmen andwomen, respectively.

The study focused more on older adults rather than young adults.

As women grow older, their oestrogen levels decrease while the

pituitary hormones increase, thus putting older women at a greater

risk of developing hypertension than men.

In our study, the prevalence of central obesity was found to be

higher in women (35.4–69.6%) than in men (1.4–30.2%). Barbosa

et al

also found a higher prevalence of central obesity in women

(65.1%) thanmen (40.1%), as didMunaretti

et al

(women 63.2%;

men 18.7%). Women have a larger amount of body fat compared

to men.

In addition, lifestyle risks such as excessive consumption

of diets rich in refined fats, oil and carbohydrates contribute to

the elevation of central obesity.

Most studies are in agreement

with our study as they have also reported the incidence of general

obesity to be higher in women than in men.

38,39

Al-Hazzaa

et al

reported that general obesity can be high in either men or women,

taking into account their behavioural risk factors such as smoking

and alcohol consumption.

We found that WC and overweight were significantly associated

with hypertension and can best be used to predict the risk of

hypertension in individuals who are obese. Sakurai

et al

also

reported a strong association between WC and hypertension

among Asians aged 19 to 33 years. Furthermore, Zhu

et al

found

that WC, overweight and hypertension were significantly correlated

in white Americans living in an urban setting.

However, our findings contradict those reported by Munaretti

et al

in which WHR was shown to be a significant predictor

of hypertension. The contradiction between the two studies is

probably because WHR is considered to have greater accuracy

because of the nature of the measurements required, compared

to WC and participants’ age categories. The study setting was also

different.

Individuals with high WC in our study were at a greater

risk of developing hypertension.

Although the current study found WC and overweight to be

the best predictors for hypertension, Hou

et al

reported that the

prediction of individuals who are at a greater risk of developing

CVD, specifically hypertension, can be improved by combining WC,

WHR and BMI. These findings are consistent with those published

previously.

24,42

However, Hans

et al

reported that the WC

parameter has several advantages compared to other parameters

because of its ease of measurement and interpretation in most

clinical settings.

The present study did not include predisposing factors such

as diet, lifestyle and level of physical activity for central obesity.

Other important factors associated with hypertension, such as

medical history, family history, alcohol intake and smoking, were

not assessed. The study had a low sample size therefore its findings

cannot be representative of all young adults in South Africa.

Conclusion

The prevalence of hypertension was high in men compared

to women. Hypertension was significantly related to WC and

overweight (the sum of four skinfolds). It is vital to investigate

the relationship between lifestyle and biological risk factors for

cardiovascular disease over time.

Acknowledgements

The financial support received from University of Limpopo, South

Africa, and the National Research Foundation of South Africa, for

the Ellisras Longitudinal Study is gratefully acknowledged. Any

opinions, findings and conclusions or recommendations expressed

in this report are those of the authors and therefore the above

funding sources do not accept any liability in regard thereto. The

authors are indebted to ELS administrators, Seleka Simon, Makata

William and Jan Mabote, for providing technical support in the

preparation of this manuscript.

References

1. He H, Kimura S, Fujisawa Y, Tomohiro A, Kiyomoto K, Aki Y, Abe Y. Dietary

L-arginine supplementation normalizes regional blood flow in Dahl-Iwai salt-

sensitive rats.

Am J Hypertens

1997;

(S4): 89S–93S.

2. Fuentes R, Ilmaniemi N, Laurikainen E, Tuomilehto J, Nissinen A. Hypertension

in developing economies: a review of population‐based studies carried out from

1980 to 1998.

J Hypertens

2000;

(5): 521–529.

3. Gersh BJ, Sliwa K, Mayosi BM, Yusuf S. Novel therapeutic concepts the epidemic

of cardiovascular disease in the developing world: global implications.

Eur Heart

2010;

(6): 642–648.

4. Jung UJ, Choi MS. Obesity and its metabolic complications: the role of adipokines

and the relationship between obesity, inflammation, insulin resistance,

dyslipidemia and nonalcoholic fatty liver disease.

Int J Mol Sci

2014;

(4): 6184–

6223.

5. Montani JP, Antic V, Yang Z, Dulloo A. Pathways from obesity to hypertension:

from the perspective of a vicious triangle.

Int J Obes

2002;

(S2): S28.

6. Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index

explains obesity-related health risk.

Am J Clin Nutr

2004;

(3): 379–384.

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