Gender-Specific Associations of Neck-Height Ratio, Physical Activity, and Relative Handgrip Strength with Blood Pressure in Young Indian Adults: Implications for Early Cardiovascular Risk Assessment in Women

Objectives: Hypertension has emerged as a significant public health issue in India. While traditional anthropometric measures have limitations in accurately evaluating body fat distribution, the neck-to-height ratio (NtHR) has emerged as a promising anthropometric indicator for cardiovascular risk assessment. This study aimed to assess the relationships between NtHR, physical activity levels, and relative handgrip strength with blood pressure (BP) in young Indian adults. Materials and Methods: This cross-sectional study recruited 415 healthy young adults (200 males and 215 females) aged 18–30 years. BP was measured using a validated Omron HBP 1300 monitor. Anthropometric measurements included neck circumference, height, weight, and waist circumference. Physical activity was assessed using the International Physical Activity Questionnaire. Relative handgrip strength was calculated by dividing maximum grip strength by body mass index (BMI). Results: NtHR demonstrated a strong positive association with both systolic and diastolic BP in both genders, with stronger associations in females. Multiple regression analysis revealed that NtHR was the strongest predictor of systolic BP in both genders (males: β = 0.731 and females: β = 0.763). Relative handgrip strength and physical activity showed significant negative associations with BP, with stronger protective effects in females. Receiver operating characteristic analysis established optimal NtHR cut-off values for detecting hypertension (males: 20.77 and females: 19.87) and prehypertension (males: 19.20 and females: 18.54). Conclusion: NtHR is a strong predictor of BP in young adults, with gender-specific patterns observed. The findings emphasize the potential of simple anthropometric measurements as effective screening tools for cardiovascular risk, particularly in resource-limited settings.