Obesity, Body Fat Distribution, and Blood Pressure in Hispanic and Non-Hispanic Whites in a National Survey

Recent data from the National Health and Nutrition Examination Survey (NHANES) indicated that despite a higher prevalence of obesity in Hispanic women than non-Hispanic White women, their hypertension prevalence did not differ. Obesity and large upper arm (UA) circumference can affect the accuracy of BP readings. Anthropometric data were used to test the hypothesis that UA circumference was related to systolic blood pressure (BP), indicating possible inaccuracy of readings in either group.

The data analysis was conducted using the NHANES 2017-March 2020 pre-coronavirus disease 2019 pandemic cycle. After excluding individuals under age 20 years, non-Hispanic Black participants, and others, the final analytic sample included (4092) non-Hispanic and Hispanic White adult females. Trained technicians measured height, weight, waist circumference, UA length and circumference, and three oscillometric systolic BP readings using four cuff sizes. Analyses accounted for the complex sampling design and weighting of the NHANES.

Compared with non-Hispanic White women, Hispanic women had lesser median height and UA length but a greater body mass index and UA circumference. Among women assigned to large cuffs, there were more Hispanics (21%), but among those assigned to extra-large cuffs, there were fewer Hispanics (10%) compared with White women. This was consistent with a more central distribution of body fat in Hispanic women. In regression analyses controlling for age, height, and weight, UA circumference was significantly associated with Hispanic ethnicity but was not associated with BP in Hispanics or Whites. Similar trends were seen in men.

Despite having a higher body mass index, fewer Hispanics than non-Hispanic White women and men required extra-large BP cuffs. There was no evidence that bias in BP readings explained the lack of excess prevalence of hypertension in Hispanic women or men.