The accuracy of anthropometric indices in detecting hypertension in Sudanese adults: a cross-sectional study

BMC Public Health. 2025 Jan 14;25(1):142. doi: 10.1186/s12889-025-21276-8.

Abstract

Background: Hypertension is an increasing health problem; hence, efforts have been made to promote the disease's early detection and modify prognoses. We aim to evaluate the accuracy of body mass index (BMI), waist circumference (WC), and waist-height ratio (WHtR) in detecting hypertension among adults in Northern Sudan.

Methods: Adults were recruited for a multi-stage sampling survey in Northern Sudan. Sociodemographic and anthropometric index (BMI, WC, and WHtR) information were collected. A receiver operating characteristic (ROC) curve with its area under the curve (AUC) was obtained, and a multivariate binary analysis was performed.

Results: Of the 301 included adults, 113 (37.5%) were females and 188 (62.5%) were males. The median (interquartile range, IQR) age was 45.0 (32.0‒59.0) years. The median (IQR) of BMI, WC, and WHtR was 25.6 (21.9‒29.7) kg/m2, 83.0 (73.0‒94.8) cm, and 0.51 (0.43‒0.58), respectively; these values were significantly higher in adults with hypertension compared with adults without hypertension. A total of 166 (55.1%) adults had hypertension. BMI (AUC = 0.69 at the cutoff 22.5 kg/m2, sensitivity = 0.89, specificity = 0.53, YI = 0.35) and WHtR for both males and females (AUC = 0.68 at the cutoff 0.48, sensitivity = 0.75, specificity = 0.60, YI = 0.35) were more accurate than WC (AUC = 0.66 at the cutoff 77.5 cm, sensitivity = 0. 77, specificity = 0.56, YI = 0.33). The multivariate binary analysis revealed that being female (adjusted odds ratio [AOR] = 2.23, 95.0% CI = 1.25‒3.97), having increased age (AOR = 1.04, 95% CI = 1.02‒1.05), and having a higher BMI (AOR = 1.10, 95% CI = 1.04‒1.16) were associated with hypertension.

Conclusion: BMI, WC, and WHtR showed moderate predictive power, suggesting that these indices have a limited role in diagnosing hypertension at the individual level and are more appropriate for population screening than for individual diagnosis. BMI performs better than WC in terms of hypertension detection.

Keywords: Age; Body mass index; Hypertension; Risk factors; Sudan; Waist circumference.

MeSH terms

  • Adult
  • Anthropometry
  • Body Mass Index*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / epidemiology
  • Male
  • Middle Aged
  • ROC Curve
  • Sudan
  • Waist Circumference*
  • Waist-Height Ratio