Association between metabolic score for visceral fat and hypertension in Korean adults: a nationwide population-based study

Background: Hypertension, one of the major risk factors for cardiovascular disease, is associated with visceral adiposity accumulation. Accordingly, we aimed to investigate the association between the metabolic score for visceral fat (METS-VF), a novel surrogate marker of visceral adiposity, and hypertension in Korean adults. Methods: This cross-sectional study included 27,565 adults from the 2019-2023 Korea National Health and Nutrition Examination Survey. Weighted multivariable logistic regression analyses were performed to examine the association between METS-VF tertiles and hypertension. Discriminatory performance was evaluated using receiver operating characteristic (ROC) curve analysis, and the areas under the ROC curves were compared with those of other adiposity-related indices. Results: The prevalence of hypertension increased significantly across the METS-VF tertiles. After adjustment for potential confounders, the odds ratios and 95% confidence intervals for hypertension were 2.50 (2.04-3.06) in the second tertile and 2.76 (2.09-3.63) in the highest tertile, compared with the lowest METS-VF tertile. Moreover, METS-VF showed greater discriminatory performance for hypertension than the other adiposity-related indices. Conclusion: These findings indicate that METS-VF is strongly associated with hypertension in Korean adults and provides a more comprehensive assessment of cardiovascular risk than conventional adiposity-related indices.