ORIGINAL ARTICLE Comparison of Different Obesity Indices for Predicting Incident Hypertension Mohsen Janghorbani 1,2 • Ashraf Aminorroaya 1 • Masoud Amini 1 Received: 16 December 2016 / Accepted: 22 January 2017 Ó Springer International Publishing Switzerland 2017 Abstract Introduction Obesity is well recognized to be an important risk factor for hypertension (HTN), but it is not clear which obesity indices have stronger association with HTN. Aim To evaluate the ability of different obesity indices, including visceral adiposity index (VAI), hypertriglyceri- demic-waist (HTGW) phenotype, a body shape index (ABSI), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR) as possible hypertension (HTN) predictor in a high- risk population. Methods Seven years follow-up data in first-degree rela- tives of consecutive patients with type 2 diabetes aged 30–70 years without diabetes and HTN with at least one follow-up examination (n = 1417) were analysed. Dis- criminatory capabilities were examined using the receiver operating characteristic (ROC) curve. Logistic regression analysis was performed to determine the strength of asso- ciation between obesity indices and HTN. Results Among the indices, the highest quintile compared with the lowest quintile of WHtR and WC was more strongly associated with HTN in age and sex adjusted models [odds ratio (95% CI); WHtR: 4.02 (2.36, 6.85) and WC: 3.26 (2.05, 5.20)]. Those with HTGW phenotype was 2.3 (1.54, 3.35) times more likely to develop HTN than those with normal WC normal triglyceride. On ROC curve analysis, WHtR (63.1%; 59.6, 66.7) and WC (61.7%, 58.0, 65.4) had the higher area under the ROC. Conclusions Although higher values of VAI, BMI, WHR and HTGW were associated with the risk of HTN, WHtR and WC was more strongly associated with the develop- ment of HTN, while the ABSI showed weaker association. Keywords Visceral adiposity index Á Hypertriglyceridemic-waist Á Hypertension Á A body shape index Á Anthropometry Á First-degree relatives Á Incidence Á Risk factor 1 Introduction As hypertension (HTN), the most important risk factor for cardiovascular disease, is rapidly increasing in prevalence, it is important to identify high risk individuals early to select persons who need further evaluation. Multiple risk factors are related to HTN, including age, genetic predis- position, unhealthy diet, physical inactivity, and obesity. Obesity is well recognized to be an important risk factor for HTN [1] and increasing in prevalence worldwide. Numerous epidemiological studies have examined the relationship between different indicators of obesity and HTN [1–8]. Nevertheless, because anthropometric mea- sures such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and a body shaped index (ABSI) [9], a recently proposed index that standardizes WC for BMI and height, cannot fully distinguish visceral fat from subcutaneous fat, and hypertensive risk is thought to be related to visceral fat rather than subcutaneous fat [10], visceral lipid accumu- lation defined as the visceral adiposity index (VAI) (a mathematical model that combines WC, BMI, triglycerides & Mohsen Janghorbani janghorbani@hlth.mui.ac.ir 1 Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 2 Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran High Blood Press Cardiovasc Prev DOI 10.1007/s40292-017-0186-3