214648 Body Mass Index and High Blood Pressure Prevalence among Asians in California: An Application of the Asian Body Mass Index Classification

Monday, November 8, 2010

Akiko Sato, MPH, RN , Department of Community Health Sciences, University of California, Los Angeles, Los Angeles, CA
Donald E. Morisky, ScD, MSPH, ScM , Department of Community Health Sciences, School of Public Health, University of California at Los Angeles, Los Angeles, CA
Background: The increase in high blood pressure and its consequences impose social and financial costs on individuals and health systems. A major hypertensive risk factor—obesity—is also rising.

Purpose: This project assessed the focal relationship between high blood pressure prevalence (HBP) and body mass index scores (BMI) among Asian adults in California.

Methods: The 2005 California Health Interview Survey data with a selected sample of 3,517 Asian participants were analyzed using the WHO BMI classification for Asians for obesity measurement. Elaboration and stratification models were applied to determine the impacts of other hypertensive risk factors on the focal relationship.

Results: Over 25% of participants have been diagnosed with HBP. High blood cholesterol, diabetes and smoking history created partial spuriousness in the focal relationship. Alcohol consumption posed partial suppression. Age caused both partial spuriousness and suppression. Obese Asians aged 55+ were 1.82 times (95% CI: 1.21-2.71), whereas younger obese Asians were 4.83 times (95% CI: 3.42-6.83) more likely to be diagnosed with HBP than their counterparts with a normal BMI. Compared with the traditional classification, use of the BMI classification for Asians doubled the proportion of obesity from 7% to 14%, and increased odds ratios by 64% for obese Asians aged 55+ and 16% for younger obese Asians.

Conclusion: Though multiple risk factors were interrelated, there was a significant focal relationship between obesity and HBP. Obesity-reduction interventions for hypertension prevention and control should target younger population. Potentially obesity prevalence and associated hypertension risk are underestimated among Asian adults in California.

Learning Areas:
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related research
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the differences in the prevalence of high blood pressure and obesity between Asian and general U.S. adult populations; Identify the relationship between BMI and high blood pressure among Asian adults in California; Explain how other hypertensive and obesity risk factors affect the relationship between BMI and high blood pressure; Formulate recommendations to guide the future design and implementation of hypertension assessment and interventions for Asian adults in California; and List the advantages and disadvantages of the application of the WHO Asian BMI classification for Asian adults in California, compared to the traditional WHO BMI classification.

Keywords: Chronic Diseases, Health Risks

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I analyzed data and wrote a manuscript .
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3362.0: Chronic Disease Prevention and Control among Asian & Pacific Islanders