Relationship between neck circumference and hypertension in the National Registry on Hypertension (the RENATA study)

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Abstract

Background: Hypertension (HT) is associated with a greater proportion of body fat. Neck circumference might provide additional clinical information to other measurements of body fat.
Objective: The aim of this study was to compare the relationship between abdominal and neck obesity and hypertension.
Methods: In the RENATA study, 4006 adults from seven cities (Buenos Aires, Córdoba, Tucumán, Mendoza, Resistencia, Corrientes and Neuquén) were randomly selected. Neck and waist circumferences were measured in 3987 subjects. Abdominal obesity (AO) was defined following the ATP III recommendations and neck obesity (NO) was considered as the upper tertile of neck circumference (≥35 cm in women and ≥41 cm in men). Hypertension was defined as average blood pressure measurements ≥140 and/or 90 mm Hg or use of antihypertensive drug therapy.
Results: In patients with normal abdominal adipose tissue, the prevalence of HT was 20.3% with normal neck circumference vs. 38.8% with NO, while in subjects with AO, the prevalence of HT was 43.7% with normal neck circumference vs. 57.4% with NO (chi square, p <0.001). Logistic regression analysis showed that, for each standard deviation of neck circumference, the risk of HT adjusted for age and gender was greater in the absence than in the presence of AO (67% vs. 17%; p <0.001).
Conclusion: The prevalence of HT was greater in subjects with obesity in both regions of the body. The association between neck circumference and the prevalence of HT was greater in subjects with normal waist circumference.