OBJECTIVE: To compare the performance of different anthropometric indices including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and a body shape index to predict high blood pressure (BP) in adolescents using the 90th and 95th percentiles as two different thresholds.
DESIGN: Cross-sectional study.
SETTING: Probability proportionate to size was used to randomly select two schools in Selangor state, Malaysia.
PARTICIPANTS: A total of 513 adolescents (58.9% women and 41.1% men) aged 12-16 years were recruited.
PRIMARY AND SECONDARY OUTCOME MEASURES: Weight, height, WC and BP of the adolescents were measured. The predictive power of anthropometric indices was analysed by sex using the receiver operating characteristic curve.
RESULTS: BMI and WHtR were the indices with higher areas under the curve (AUCs), yet the optimal cut-offs to predict high BP using the 95th percentile were higher than the threshold for overweight/obesity. Most indices showed poor sensitivity under the suggested cut-offs. In contrast, the optimal BMI and WHtR cut-offs to predict high BP using the 90th percentile were lower (men: BMI-for-age=0.79, WHtR=0.46; women: BMI-for-age=0.92, WHtR=0.45). BMI showed the highest AUC in both sexes but had poor sensitivity among women. WHtR presented good sensitivity and specificity in both sexes.
CONCLUSIONS: These findings suggested that WHtR might be a useful indicator for screening high blood pressure risk in the routine primary-level health services for adolescents. Future studies are warranted to involve a larger sample size to confirm these findings.
* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.