Acta Scientific Medical Sciences (ISSN: 2582-0931)

Research ArticleVolume 5 Issue 3

Association Between Body Mass Index and Blood Pressure Among Rural Indian Adults

Partha Sarathi Datta*

Department of Public Health Research, Rural and Urban Social Welfare Organization, India

*Corresponding Author: Partha Sarathi Datta, Department of Public Health Research, Rural and Urban Social Welfare Organization, India.

Received: January 21, 2021; Published: February 16, 2021

Citation: Partha Sarathi Datta. “Association Between Body Mass Index and Blood Pressure Among Rural Indian Adults”. Acta Scientific Medical Sciences 5.3 (2021): 20-24.

Abstract

Introduction: Measures of Body Mass Index (BMI) and blood pressure are important for assessing the health status of adults.

Objectives: To find out the association between the BMI and blood pressure among rural adults of Indian origin.

Methods: Anthropometric measurements, such as stature, body weight, were measured using standard methodology. Systolic (SBP) and Diastolic (DBP) blood pressure were recorded according to a proper methodology. A schedule was used to collect data on the socio-demographic profile, behavioral activity, weekly physical activity and family history of hypertension etc.

Results: Among the total study participants 259 (19.98%) were overweight and 98 (7.56%) were obese. 28.47% of the study participants had stage-I hypertension while 71.53% had normal blood pressure. A significant correlation was observed between BMI and Blood pressure.

Conclusion: The rural participants of studied area were prone to risk factors related to high blood pressure.

Keywords: Body Mass Index; Blood Pressure; Rural Indians

Introduction

  Assessing nutritional status is the overall development of the human health class. Low nutrition frequencies are now the number one public health problem in developing countries around the world. Assessing nutritional level plays an important role in developing nutritional interventional plans for specific communities [1]. The major cause for malnutrition in India is economic differences. Due to the low socio-economic status of some communities, their diet often lacks both quality and quantity. Women who experience malnutrition are less likely to have healthy babies. In India, mothers mainly lack basic knowledge in feeding children. In addition, new born babies are not able to get proper amount of nutrition from their mothers. Nutritional deficiencies lead to long term damage to both individuals and communities.

  Unlike their well-fed peers malnourished individuals are at higher risk of developing various infectious diseases such as pneumonia, tuberculosis etc, leading to higher mortality rates. In addition, malnourished people become less fertile at work. On the other hand, excess nutrition also has different consequences. Various non-communicable diseases such as cardiovascular diseases, diabetes, cancers and chronic respiratory diseases are strongly associated with obesity [2]. The overall trend of weight and obesity in India is expected to increase significantly by 2040, especially among rural residents and older Indians [3].

  Body Mass Index (BMI) is emphatically and autonomously associated with death and disorders from hypertension, Type-II Diabetes Mellitus and other cardiovascular diseases globally [4]. Due to rapid modernization and urbanization a number of developing countries have been observing nutritional transitions worldwide [5]. In various Asian countries, this nutritional transition is rapid. In rural India, the average living standards have been rising during the last thirty years which directly leads nutritional transition. Westernization of food has led to overweight and obesity, which are considering a major threat to the health of rural Indian people [6]. Several studies in India have found that this nutritional transition greets chronic diseases and obesity. Studies have revealed that obesity is strongly associated to high blood pressure, dyslipidemia, diabetes etc. [7].

  Beside this, High blood pressure is one of the major risk factors for cardiovascular diseases. High blood pressure or hypertension is a public health concern due to its high prevalence among different age and sex groups of adult populations globally [8]. High blood pressure is considered to cause 7.5 million annual deaths worldwide which are estimated to be increased to 1.56 billion adults by 2025 [9]. In South Asian countries where the burden of cardiovascular disease is high, India is increasingly faced with the triple burden of hypertension and other cardiovascular diseases, along with infection and malnutrition [10]. The association between BMI and blood pressure has long been the subject of epidemiological research. A large number of studies have revealed the strong association between BMI and blood pressure among south Asian populations including Indians [11,12].

  The present cross-sectional study was aimed to find out the association between the Body Mass Index (BMI) and blood pressure among rural adults of Indian origin.

Materials and Methods

  This cross-sectional study was carried out among 1296 adults, aged 21 to 60 years, of these, males and females were 708 and 588 respectively from October 2017 to January 2020. Field survey was carried out in the rural areas to collect data. The participants were selected through simple random technique from ten villages under five Gram Panchayats of West Bengal, India.

  The participants were divided into four different age groups with ten years interval each to study the age trend of different variables like stature, body weight and BMI. Anthropometric measurements, such as stature and body weight were measured using standard instruments and techniques given by Weiner and Lourie (1981) [13]. Measurements have been taken on the subjects wearing minimal and light apparel. Systolic (SBP) and Diastolic (DBP) blood pressure were recorded according to a proper technique from each participant. BMI (weight/height2) was calculated and classified according to the proposed criteria of World Health Organization (WHO) (underweight < 18.5, normal = 18.5-24.5, overweight = 25.0-29.9 and obese ≥30 [14]. In the present study, all the subjects having BMI ≥30 were taken as obese.

  Normal blood pressure was taken as < 120 mmHg (SBP) and <80 mmHg (DBP). Blood pressure values of 120-139 mmHg for SBP and 80-89 mmHg for DBP were classified as prehypertensive. Stage-I hypertension was taken as 140-159 mmHg for SBP and 90-99 mmHg for DBP, whereas blood pressure of >160 mmHg for SBP and >100 mmHg for DBP were classified as stage II hypertension (JNC 2007) [15].

  The data on behavioural activity and weekly physical activities were collected using a standard schedule. A food frequency schedule was used to collect data on weekly consumption of food.

  Statistical software SPSS version 22 was used to carry out statistical analysis. Descriptive statistics of mean and standard deviation were used to examine the collected data. Beside descriptive statistics, to test the differences between the age groups, t-test was done. To determine the association between BMI and blood pressure, correlation analyses were done.

Results

  Table 1 shows the basic measurements and calculation of males and females participants. Mean values of stature, body weight, SBP, DBP and BMI were found to be significantly higher in males as compared with females.

Parameters

Males

(Mean ± SD)

Females

(Mean ± SD)

Stature (cm.)

164.2 ± 4.28

153.8 ± 5.76

Weight (kg.)

68.8 ± 6.42

61.5 ± 9.24

SBP (mmHg)

129.7 ± 8.02

121.3 ± 9.07

DBP (mmHg)

88.3 ± 7.43

84.2 ± 9.39

BMI (Kg/mt2)

25.33 ± 3.92

23.88 ± 2.69

Table 1: Significance of the sex difference between various parameters (N = 1296).

  Table 2 shows the prevalence of hypertension (HTN) according to demographic and life style factors of the study participants. A total of 1296 rural adults were included in the present study of which 708 (54.63%) were males and 588 (45.37%) were females. Of the total study population, majority 403 (31.09%) were in the age group 21-30 years and minimum number of the participants is present in the age group 51-60 years (18.29%). Among the total study participants 259 (19.98%) were overweight and 98 (7.56%) were obese. 38.34% participants were involved in little or no physical activities. A total of 17.59% study subjects were consumed alcohol and 32.17% were smokers. Majorities (96.37%) were involved in non-vegetarian diet and 36.26% participants were intake extra salt in their diet. Beside this, 54.74% males and 45.26% females were high blood pressure (Hypertension Stage-I). 29.27% participants aged 41-50 years had high blood pressure. 35.51% overweight participants and 50.41% physically inactive participants were hypertensive among study participants. Again 78.32% smokers were examined by high blood pressure but 74.53% non alcohol consumers were hypertensive. 97.83% and 80.76% participants were hypertensive who were non-vegetarian and took extra salt in their diet respectively.

Parameters

Number (%)

HTN (%)

P value

Sex

 

 

 

Male

708 (54.63)

202 (54.74)

0.05

Female

588 (45.37)

167 (45.26)

Age Group(Yrs)

 

 

 

21-30

403 (31.09)

92 (24.93)

0.01

31-40

305 (23.53)

86 (23.31)

41-50

351 (27.09)

108 (29.27)

51-60

237 (18.29)

83 (22.49)

BMI

 

 

 

Under nutrition

106 (8.18)

19 (5.15)

0.33

Normal

833 (64.28)

166 (44.98)

Overweight

259 (19.98)

131 (35.51)

Obese

98 (7.56)

53 (14.36)

Physical Activity

 

 

 

Heavy

193 (14.89)

74 (20.05)

0.21

Moderate

606 (46.75)

109 (29.54)

Sedentary

497 (38.34)

186 (50.41)

Alcohol Consumption

 

 

 

Yes

228 (17.59)

94 (25.47)

0.45

No

1068 (82.41)

275 (74.53)

Smoking Tobacco

 

 

 

Yes

417 (32.17)

289 (78.32)

0.64

No

879 (67.82)

80 (21.68)

Diet

 

 

 

Vegetarian

47 (3.62)

8 (2.17)

0.46

Non-vegetarian

1249 (96.37)

361 (97.83)

Added salt intake

 

 

 

Yes

470 (36.26)

298 (80.76)

0.62

No

826 (63.73)

71 (19.24)

Table 2: Prevalence of hypertension according to demographic and life style factors (N = 1296).

  Table 3 shows the Blood pressure profile of participants. 28.47% of the study participants had stage-I hypertension while 71.53% had normal blood pressure.

Blood Pressure

Total

n (%)

Male

n (%)

Female

n (%)

P value

High (Stage-I)

369 (28.47)

202 (15.58)

167 (12.89)

0.79

Normal

927 (71.53)

506 (39.05)

421 (32.48)

Table 3: Blood pressure profile of participants (N = 1296).

  Table 4 shows the correlation between body mass index and blood pressure of participants. An association was observed between BMI and Blood pressure. The r value shows a significant correlation between body mass index and blood pressure.

Blood Pressure

High

n (%)

Normal

n (%)

P value

r

BMI

 

 

 

0.33

 

0.84

Under nutrition

19 (1.47)

87 (6.71)

Normal

166 (12.81)

667 (51.46)

Overweight

131 (10.11)

128 (9.88)

Obese

53 (4.08)

45(3.48)

Table 4: Correlation between body mass index and blood pressure of participants (N = 1296).

   Comorbidities were present in all patients included in the study. Most patients presented more than six comorbidities. Among the comorbidities, the presence of chronic obstructive pulmonary disease (COPD) was more characteristic for obese patients: 21% vs. 8%, (p < 0.05). The most common comorbidities found in patients were: chronic heart failure 45% vs. 48%, diabetes mellitus 20% vs. 16%, chronic liver disease 11% vs. 9% and chronic renal failure 9% vs. 11%, (p > 0.05), in group 1 and group 2, respectively.

Discussion

  In this present cross-sectional study several socio-economic, demographic and lifestyle variables are taken into consideration for the examining the nutritional status through BMI and blood pressure level among rural adults. The present study was conducted among adults living in rural areas under North 24 Parganas district of West Bengal, India. In North 24 Parganas district, most of the villagers follow Hinduism. Beside this, the other major religion in the villages of North 24 Parganas is Islam. The villages of North 24 Parganas are home to the ethnic groups like Santals, Oraon, Munda, Lodha, Shabar etc. In rural North 24 Parganas, there are several villages in which the percentage of Scheduled Tribe (ST), Scheduled Caste (SC) and Other Backward Classes (OBC-A and OBC-B) population is nearly 90 percent.

  In this study, BMI is classified according to the WHO as underweight, normal, overweight, and obese. Overweight and obesity are risk factors for many diseases, including high BP [16-18]. In this present study, 259 participants (19.98%) were overweight and 98 (7.56%) were obese. Out of total overweight and obese participants, 52.05% were stage-I hypertensive.

  Physical activity is generally recommended as an important lifestyle change that can help high blood pressure [19,20]. In this study, 38.34% rural people were engaging in low or no physical activities. Out of them, 37.57% were examined by stage-I hypertensive. A study revealed that heavier consumption of alcohol (>20 g⁄day) is associated with the risk of development of high blood pressure in both sexes. In case of women, light to moderate consumption of alcohol (<20 g⁄day) had a reduced risk of high blood pressure, while men had an increased risk [21]. In this present study 74.53% study participants didn’t consume alcohol while examined hypertensive. Tobacco smoking causes high blood pressure, although many studies have showed that smokers have the same or lower blood pressure than non-smokers [22]. 78.32% study participants were hypertensive who smokes tobacco daily. The close relation between high blood pressure and extra intake of salt in diet is widely recognized by several studies. Extra intake of salt in diet has also reduced the chances of cardiovascular diseases [23]. In this present study, 80.76% participants took extra salt in their diet and also examined hypertensive.

Conclusions

   The present study found that rural participants of studied area were prone to risk factors related to high blood pressure. The tendency to hypertension begins in middle and late adulthood, but if this trend continues in rural India, people will have a higher rate of illness and death in later life. Thus, lifestyle changes and regular health check-ups with awareness in rural areas will help to improve the present unhealthy condition and reduce the tendency of hypertension among rural residents.

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    Copyright: © 2021 Partha Sarathi Datta. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



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