Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans

Ann Intern Med. 2004 Jun 15;140(12):992-1000. doi: 10.7326/0003-4819-140-12-200406150-00008.


Background: Visceral adiposity is generally considered to play a key role in the metabolic syndrome.

Objective: To examine the relationship between directly measured visceral adiposity and the risk for incident hypertension, independent of other adipose depots and fasting plasma insulin levels.

Design: Community-based prospective cohort study with 10- to 11-year follow-up.

Setting: King County, Washington.

Participants: 300 Japanese Americans with a systolic blood pressure less than 140 mm Hg and a diastolic blood pressure less than 90 mm Hg who were not taking antihypertensive medications, oral hypoglycemic medications, or insulin at study entry.

Measurements: Abdominal, thoracic, and thigh fat areas were measured by using computed tomography. Total subcutaneous fat area was calculated as the sum of these fat areas excluding the intra-abdominal fat area. Hypertension during follow-up was defined as having a systolic blood pressure of 140 mm Hg or greater, having a diastolic blood pressure of 90 mm Hg or greater, or taking antihypertensive medications.

Results: There were 92 incident cases of hypertension during the follow-up period. The intra-abdominal fat area was associated with an increased risk for hypertension. Multiple-adjusted odds ratios of hypertension for quartiles of intra-abdominal fat area (1 = lowest; 4 = highest) were 5.07 (95% CI, 1.75 to 14.73) for quartile 3 and 3.48 (CI, 1.01 to 11.99) for quartile 4 compared with quartile 1 after adjustment for age, sex, fasting plasma insulin level, 2-hour plasma glucose level, body mass index, systolic blood pressure, alcohol consumption, smoking status, and energy expenditure through exercise (P = 0.003 for quadratic trend). The intra-abdominal fat area remained a significant risk factor for hypertension, even after adjustment for total subcutaneous fat area, abdominal subcutaneous fat area, or waist circumference; however, no measure of these fat areas was associated with risk for hypertension in models that contained the intra-abdominal fat area.

Limitations: It is not known whether these results pertain to other ethnic groups.

Conclusions: Greater visceral adiposity increases the risk for hypertension in Japanese Americans.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abdomen / pathology*
  • Adipose Tissue / pathology*
  • Adult
  • Aged
  • Asian Americans
  • Blood Glucose / metabolism
  • Body Mass Index
  • Cholesterol, HDL / blood
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / etiology*
  • Insulin / blood
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / complications*
  • Obesity / pathology*
  • Prospective Studies
  • Risk Factors


  • Blood Glucose
  • Cholesterol, HDL
  • Insulin