The Relationship of Body Mass Index and Waist-Hip Ratio on the 9-Year Incidence of Diabetes and Hypertension in a Predominantly African-origin Population

Purpose: To provide 9-year incidence data for diabetes and hypertension and evaluate the relationship of body mass index (BMI) and waist-hip ratio (WHR) on these comorbidities in an African Caribbean population. Methods: This was a longitudinal, population-based cohort study, including 4,631 participants at baseline; 2,793 were reexamined at the 9-year follow-up. Diabetes was defined by self-reported history and/or glycosylated hemoglobin measurement; hypertension was defined as systolic blood pressure (BP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or use of antihypertensive treatment. Incidence rates were based on persons without such conditions at baseline. Results: The 9-year incidence of hypertension (95% confidence interval) was higher in women (37.5% [34.0-41.2]) than men (30.6% [26.9-34.6]), whereas the incidence of diabetes was similar for both genders (14%). Body size was related to both conditions; however, the incidence of hypertension was more strongly associated with WHR, whereas diabetes had a stronger association with BMI. Conclusions: Incidence rates for diabetes and hypertension were high in this cohort, and the relationship of BMI and WHR on these comorbidities was significant. These findings suggest the need to develop tailored interventions and preventive strategies in this African Caribbean and similar high-risk populations.