Beyond BMI: The Role of Abdominal Obesity in Hypertension Risk Among Adults Aged 45 Years and Older in India

Hypertension is highly prevalent among adults aged 45 years and older in India, yet limited evidence exists on the combined associations of waist circumference (WC) and body mass index (BMI) with hypertension. This study examined their independent and joint associations with hypertension using Wave 1 (2017-18) of the Longitudinal Ageing Study in India (LASI) among 59,658 adults aged 45 years and older. Hypertension was defined as measured blood pressure ≥140/90 mmHg. Multivariable logistic regression assessed associations across combined WC-BMI categories. Overall hypertension prevalence was 31.3%. Individuals with normal BMI but large WC had higher odds of hypertension (adjusted odds ratio [AOR] = 1.37; 95% confidence interval [CI]: 1.19-1.58). Obese individuals with large WC had the highest odds (AOR = 1.77; 95% CI: 1.45-2.17). Both central and general obesity were independently associated with hypertension. Routine WC assessment alongside BMI may improve identification of high-risk individuals in India's middle-aged and older population.