Hypertension and Anthropometric Indicators in Urban Male Youth of Moradabad: JNC 8 2014 vs. ACC/AHA 2017 Guidelines

Abstract

Introduction: JNC 8 2014 and the recent ACC/AHA 2017 guidelines used to classify hypertension differ a lot in defining various stages of hypertension and thus will change the prevalence of the disease. However, the relationship between anthropometric parameters and blood pressure considering the two hypertension guidelines in urban Indian population is still unclear. Aim: To compare the anthropometric parameters and prevalence of prehypertension and hypertension between two hypertension guidelines for urban young male adults in Moradabad. Materials and Methods: This cross-sectional study was done in 2018, using standard protocol for measuring blood pressure and anthropometric parameters in 444 subjects residing in urban areas of Moradabad (18-25 years of age). Subjects were classified using JNC 8 and ACC/AHA 2017 into 8 BP categories. ANOVA was used to compare the anthropometric parameters between the BP categories. Results: Waist Circumference (WC), Skinfold Thickness at Biceps (STB) and at Triceps (STT) was significantly higher in JNC Stage 2 as compared to ACC/AHA Stage 2. Additionally, waist hip ratio, waist height ratio, STB and STT were significantly higher in JNC Stage 2 as compared to JNC Prehypertension but not for ACC/AHA classification The prevalence of prehypertension and hypertension (stage 1 and stage 2) was 33.11% and 13.06% according to JNC 8 2014, respectively; while, it is 9.91% and 36.26% according to AHA/ACC 2017 guidelines, respectively. WC & BMI, the strongest predictors of hypertension, were significantly more in hypertensive than normal subjects according to both the classifications. Conclusion: New ACC/AHA 2017 classification increases the prevalence of hypertension and decreases the prevalence of prehypertension in young urban males of Moradabad. JNC 8 2014 classifies prehypertensives with higher peripheral obesity as compared to ACC/AHA 2017. While, ACC/AHA 2017 misses higher hypertension grades that have increased peripheral obesity at the biceps as compared to JNC 8 2014. The two classifications show different anthropometric parameters at various stages. Since obesity management is interrelated with hypertension management, there is a need of obesityhypertension classification.

Keywords

• blood pressure classification
• body mass index
• high blood pressure
• prehypertension
• prevalence
• waist circumference