Body mass index, abdominal adiposity, weight gain and risk of developing hypertension: a systematic review and dose–response meta‐analysis of more than 2.3 million participants

Summary Objective This study aimed to test the association between anthropometric measures and risk of developing hypertension. Methods We did a systematic search using PubMed and Scopus, from inception up to January 2017. Prospective cohort studies reporting the risk estimates of hypertension for three or more quantitative categories of indices of general and abdominal adiposity were included. Summary relative risks were calculated using random‐effects models. Results Fifty‐seven prospective cohort studies were included. Summary relative risks were 1.49 (95% confidence interval [CI]: 1.41, 1.58; I 2 = 97.4%, n = 50) for a five‐unit increment in body mass index, 1.27 (95%CI: 1.15, 1.39; I 2 = 95.0%, n = 14) for a 10‐cm increment in waist circumference, 1.16 (95%CI: 1.09, 1.23; I 2 = 77.8%, n = 5) for weight gain equal to a one‐unit increment in BMI, and 1.37 (95%CI: 1.24, 1.51; I 2 = 76.4%, n = 8) and 1.74 (95%CI: 1.35, 2.13; I 2 = 58.9%, n = 4) for a 0.1‐unit increment in waist‐to‐hip ratio and waist‐to‐height ratio, respectively. The risk of hypertension increased continuously with increasing all anthropometric measures, and also along with weight gain. Conclusion Being as lean as possible within the normal body mass index range may be the best suggestion in relation to primary prevention of hypertension.