Determining New Anthropometric Markers for Screening Hypertension in the Caribbean Region

Abstract

Introduction: The prevalence of hypertension in the Caribbean is high (26% in Saint (St.) Kitts). It contributes to 51% of deaths secondary to ischemic heart disease and hence being a leading cause of death in the Caribbean region. Aim: To determine the association between Indices using height, waist, hip, thigh, arm, and wrist circumference (cm) with development of hypertension and to compare existing markers in test subjects and assessing their feasibility as predictive indicators for the development of hypertension. Materials and Methods: In the present cross-sectional study, a total of 635 subjects were involved in the study which included health centers and health camps in St. Kitts (West Indies). Study was conducted from December 2019 to November 2020. Height to Waist Ratio (HtWR), Arav Body Index (ABI), Waist to Thigh Ratio (WTR) and Wrist to Arm Ratio (WAR) was compared to common existing markers such as Waist to Height Ratio (WHtR), Waist to Hip Ratio (WHR) and Body Mass Index (BMI). Statistical analysis was done using using IBM Statistical Package for the Social Sciences (SPSS) version 23.0. Results: A total of 635 participants were included with most of the participants (n=540) between age group of 40 to 70 years, 35.4% (n=225) of participants were males and 64.6% (n=410) were females. In the present study, 47.92% (n=304) were non hypertensive and 52.1% (n=331) were hypertensive. In males, Area Under Receiver Operating Curve (AUROC) of HtWR (0.690) and Inverse ABI (0.632) was superior as compared to other anthropometric markers for predicting the development of hypertension and Waist to Thigh Ratio (WTR) (0.687) was superior in females. Among females recommended cut-off values for WTR is 1.6 and among males for HtWR and Inverse ABI were 2.3 and 2.84, respectively. Conclusion: Height to waist ratio and inverse ABI were more reliable markers in males for predicting the development of hypertension whereas, WTR being more reliable in females in population of St. Kitts. This will help at-risk individuals to take preventive measures like lifestyle modification.

Keywords

• anthropometric measures
• arav body index
• height to waist ratio
• receiver operating characteristics