Association Between Body Mass Index and Hypertension Among Indigenous Adults in Canada: A Cross-Sectional Analysis of...

Background Hypertension and obesity remain important public health concerns among Indigenous populations in Canada because of their association with cardiovascular disease and related chronic conditions. Limited recent national evidence has examined the relationship between body mass index and hypertension among Indigenous adults in Canada. Objective To examine the association between body mass index classification and hypertension among Indigenous adults in Canada using data from the 2022 Canadian Community Health Survey. Methods This cross-sectional study analyzed data from the 2022 Canadian Community Health Survey Public Use Microdata File. The study included 1,632 Indigenous adults aged 18 years and older, representing a weighted population of 607,892 individuals. Survey-weighted descriptive statistics and multivariable logistic regression analyses were performed while accounting for the complex survey design and bootstrap variance estimation. Hypertension was the outcome variable, while body mass index classification was the primary exposure variable. Results Among participants with hypertension, 92,384 (87.03%) were classified as overweight or obese, compared with 351,946 (70.14%) among those without hypertension. Adults aged 50-64 years had significantly higher odds of hypertension compared with adults aged 18-34 years (adjusted odds ratio (aOR)=9.54, 95% confidence interval (CI): 2.70-33.69, p<0.001). Participants aged 65 years or older also had higher odds of hypertension (aOR=13.59, 95% CI: 3.68-50.14, p<0.001). High cholesterol was significantly associated with hypertension (aOR=2.40, 95% CI: 1.23-4.70, p=0.011). Overweight or obese participants had higher odds of hypertension compared with underweight or normal weight participants; however, the association did not reach statistical significance after adjustment for demographic, behavioral, and clinical factors (aOR=2.15, 95% CI: 0.95-4.88, p=0.066). Conclusion This study highlights the burden of hypertension among Indigenous adults in Canada. Older age and high cholesterol were significantly associated with hypertension. Although overweight or obese participants demonstrated higher odds of hypertension, the association did not reach statistical significance after adjustment. Further longitudinal studies are needed to better understand the relationship between body mass index and hypertension among Indigenous populations in Canada.