Body mass index and the prevalence of hypertension and dyslipidemia

Objective: To describe and evaluate relationships between body mass index ( BMI) and blood pressure, cholesterol, high-density lipoprotein-cholesterol (HDL-C), and hyper tension and dyslipidemia. Research Methods and Procedures: A national survey of adults in the United States that included measurement of height, weight, blood pressure, and lip ids (National Health and Nutrition Examination Survey III 1988-1994). Crude age-adjusted, age-specific means and proportions, and multivariate odds ra tios that quantify the association between hypertension or dyslipidemia and BMI, controlling for race/ethnicity, education, and smoking habits are pre sented. Results: More than one-half of the adult population is overweight (BMI of 2 5 to 29.9) or obese (BMI of greater than or equal to 30). The prevalence of high blood pressure and mean levels of systolic and diastolic blood pressu re increased as BMI increased at ages younger than 60 years. The prevalence of high blood cholesterol and mean levels of cholesterol were higher at BM I levels over 25 rather than below 25 but did not increase consistently wit h increasing BMI above 25. Rates of low HDL-C increased and mean levels of HDL-C decreased as levels of BMI increased. The associations of BMI with hi gh blood pressure and abnormal lipids were statistically significant after controlling for age, race or ethnicity, education, and smoking; odds ratios were highest at ages 20 to 39 but most trends were apparent at older ages. Within BMI categories, hypertension was more prevalent and HDL-C levels we re higher in black than white or Mexican American men and women. Discussion: These data quantify the strong associations of BMI with hyperte nsion and abnormal lipids. They are consistent with the national emphasis o n prevention and control of overweight and obesity and indicate that blood pressure and cholesterol measurement and control are especially important f or overweight and obese people.