Association between body fat percentage and hypertension in participants of the Ship-Brazil Study

Abstract Introduction Hypertension (HTN) is a chronic condition frequently associated with an increased Body Fat Percentage (BFP). Studies indicate that BFP provides a more precise representation of adiposity. Factors such as obesity, advanced age, and anthropometric characteristics linked to high cardiovascular risk influence the prevalence of HTN. Few studies have explored the relationship between BFP and HTN in Brazil despite its relevance. Objective To analyse the potential association between BFP and HTN in participants aged 20 to 79 years from the "SHIP-Brazil" study. Methods This is a cross-sectional, population-based epidemiological study comprising 632 participants of both sexes, aged 20 to 79 years, who underwent a tetrapolar Bioelectrical Impedance Analysis to determine BFP. Blood pressure was measured using an electronic device, in accordance with the international guidelines. Covariates such as sex, age, marital status, ethnicity, Germanic cultural background, socioeconomic status, physical activity, tobacco use, and alcohol consumption were also obtained through a structured questionnaire. Trained examiners collected anthropometric measurements. BFP was compared between hypertensive and non-hypertensive individuals in the overall sample and stratified by sex and age group. The association between BFP quartiles and HTN was estimated using Poisson regression, in both crude and adjusted models. A p-value <0.05 was considered statistically significant. Results In the sample, the mean BFP was higher in the hypertensive group (34% vs 28%; t= -6.29, p<0.001). Upon analysis by sex, it was observed that hypertensive women exhibited a higher mean BFP than hypertensive men (42% vs 27%; tm= -8,60; pm<0,001; th = -6,29; ph <0,001). Regarding age, there was a progressive increase in BFP in both groups, with the highest means observed among hypertensive participants aged 60–79 years (41% vs 35% vs 32%; t60-79 = -3,60; p60-79 <0,001; t40-59 = -3,48; p40-59 = 0,001; t20-39 = -0,44; p20-39 = 0,659). In the fully adjusted Poisson regression model (adjusted with all covariates), an increase in prevalence ratios for hypertension was observed among participants with BFP=22.8-30.1 (PR=2.0; 95%CI 1.1 – 3.7; p=0.023), BFP=30.1-37.4 (PR=2.7; 95%CI 3.3 – 5.3; p=0.005), and BFP ≥ 37.5 (PR=4.3; 95%CI 1.8 – 10.3; p=0.001) compared to individuals with BFP <22.8. Conclusion Our results suggest that BFP is an independent predictor of HTN. BFP may be considered a clinically relevant screening tool, as hormonal mechanisms and adipose tissue distribution contribute to the modulation of cardiovascular risk.Association between BFP and HTN