The association between body mass index and abdominal obesity with hypertension among South Asian population: findings from nationally representative surveys

Objective This study aimed to determine the association between body mass index (BMI) and abdominal obesity with hypertension among the South Asian adults (18–69 years). Methods This study utilized the nationally representative WHO STEPwise approach to surveillance data ( n = 24,413) from Afghanistan, Bangladesh, Bhutan, Nepal, and Sri Lanka. Hypertension was defined as having a systolic blood pressure of 140 mmHg or higher, a diastolic blood pressure of 90 mmHg or higher, and/or taking antihypertensive medications. A waist circumference ≥ 90 cm in men and ≥ 80 cm in women was considered as abdominal obesity. BMI was categorized according to Asia-specific cutoff and overweight was defined as BMI of 23.0–27.5 kg/m 2 and obesity was defined as BMI ≥ 27.5 kg/m 2 . Multivariable logistic regression analyses were conducted to identify the association between BMI and abdominal obesity with hypertension. The odds ratio (OR) with a 95% confidence interval (CI) was reported. Results Abdominal obesity increased the odds of hypertension 31%-105% compared to those who did not have abdominal obesity (OR: Afghanistan: 2.05; 95% CI: 1.27–3.31; Bangladesh: 1.55; 95% CI: 1.18–2.04; Bhutan: 1.31; 95% CI: 1.03–1.66; Nepal: 1.69; 95% CI: 1.31–2.18; Sri Lanka:1.55; 95% CI: 1.23–1.95). The odds increased among participants with both overweight/obesity and abdominal obesity. In all five countries under study, participants with both overweight and abdominal obesity (OR: Afghanistan: 2.75; 95% CI: 1.75–4.34; Bangladesh: 2.53; 95% CI: 1.90–3.37; Bhutan: 2.22; 95% CI: 1.64–3.00; Nepal: 2.08; 95% CI: 1.54–2.81; Sri Lanka: 2.29; 95% CI: 1.77–2.98), as well as those with obesity and abdominal obesity (OR: Afghanistan: 6.94; 95% CI: 4.68–10.30; Bangladesh: 2.95; 95% CI: 2.19–3.97; Bhutan: 3.02; 95% CI: 2.23–4.09; Nepal: 4.40; 95% CI: 3.05–6.34; Sri Lanka: 3.96; 95% CI: 2.94–5.32), exhibited higher odds of having hypertension as compared to participants with a normal BMI and no abdominal obesity. Conclusion Having both abdominal obesity and overweight/obesity increased the odds of hypertension among South Asian adults. Preventing overweight/obesity and abdominal obesity is necessary for preventing the burden of hypertension in South Asia. Graphical Abstract