The association between calf circumference and mid-upper arm circumference and prevalence of hypertension: findings from the pure china study

Objective: To investigate the association of calf circumference (CC), mid-upper arm circumference (MUAC) and their derivative indexes (waist-to-arm and waist-to-calf circumference ratio) with prevalence of hypertension. Methods: A total of 47,677 individuals aged 35–70 years with measurement of CC, MUAC and blood pressure were available for analysis. CC and MUAC were measured under standardized training. The association of CC and MUAC with hypertension were tested in logistic regression analyses and reported as odds ratio (OR) with 95% CI. Subgroup analysis for BMI was conducted. Results: CC and MUAC were positively correlated with hypertension in the crude model. When adjusted for the BMI and waist, larger CC and MUAC were associated with a lower hypertension prevalence rate. It was stable after adjusted for demographic characteristics, lifestyle behaviors and health status [OR of 0.96(0.91, 1.03), 0.90(0.83, 0.97), and 0.85(0.80, 0.90) for Q2, Q3, and Q4 for CC, P for trend < 0.05, respectively; OR of 1.00(0.94, 1.07), 0.94(0.88, 1.00), and 0.82(0.76, 0.88) for Q2, Q3, and Q4 for MUAC, P for trend < 0.05, respectively]. Larger waist-to-arm and waist-to-calf circumference ratios were correlated with a higher risk of hypertension. For the overweight (BMI 24–28 kg/m2) group, as the CC or MUAC increased, a significant trend for a lower prevalence of hypertension was observed [OR of 0.87(0.77, 0.98), 0.84(0.75, 0.95), and 0.79(0.69, 0.90) for Q2, Q3, and Q4 for CC, P for trend < 0.05, respectively; OR of 0.86(0.76, 0.97), 0.77(0.69, 0.87), and 0.71(0.63, 0.80) for Q2, Q3, and Q4 for MUAC, P for trend < 0.05, respectively].