Body Composition

Visceral Adiposity Is Independently Associated with Hypertension in Thai Adults: A Case-Control Study.

TL;DR

A higher BIA-derived visceral fat level was independently associated with hypertension among Thai adults after adjustment for age, sex, and skeletal muscle mass, with each one-unit increase in visceral fat level associated with a 16% increase in the odds of hypertension.

Key Findings

Individuals with hypertension were significantly older and more likely to be male compared with normotensive participants.

  • Case-control study included 208 Thai adults aged ≥18 years: 103 normotensive individuals and 105 individuals with hypertension.
  • Hypertensive participants were significantly older than normotensive participants (p < 0.001).
  • Hypertensive participants were more likely to be male (p = 0.010).
  • In the multivariable model, older age had an OR of 1.06 (95% CI: 1.04–1.09; p < 0.001) and male sex had an OR of 5.35 (95% CI: 1.69–16.95; p = 0.004) for hypertension.

Individuals with hypertension exhibited significantly greater adiposity-related characteristics across multiple body composition measures.

  • Hypertensive participants had higher body weight (p = 0.001), body mass index (p = 0.001), body fat percentage (p = 0.023), fat mass (p < 0.001), visceral fat level (p < 0.001), and waist-to-hip ratio (p = 0.037) compared with normotensive participants.
  • Body composition was assessed using bioelectrical impedance analysis (BIA), which captured overall and regional parameters including visceral fat level, fat mass, body fat percentage, and skeletal muscle mass.
  • All adiposity-related differences between groups were statistically significant.

All blood pressure indices were significantly higher in hypertensive participants compared with normotensive participants.

  • Hypertensive participants had higher systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), and rate-pressure product (RPP).
  • All blood pressure index differences were statistically significant (all p < 0.001).

Visceral fat level was independently associated with hypertension after adjustment for age, sex, and skeletal muscle mass.

  • In the fully adjusted Model 3, higher visceral fat level was associated with hypertension with an OR of 1.16 (95% CI: 1.06–1.26; p < 0.001).
  • Each one-unit increase in visceral fat level was associated with a 16% increase in the odds of hypertension.
  • The model included age, sex, and skeletal muscle mass as covariates.
  • The final model demonstrated acceptable discrimination with an AUC of 0.79 (95% CI: 0.72–0.85).

Skeletal muscle mass was not independently associated with hypertension in the fully adjusted multivariable model.

  • In Model 3, skeletal muscle mass showed no independent association with hypertension (OR = 1.03, 95% CI: 0.95–1.12; p = 0.438).
  • Skeletal muscle mass was included as a covariate alongside age, sex, and visceral fat level.
  • The lack of association persisted after adjustment for the other covariates in the model.

The authors concluded that visceral fat distribution may provide complementary information in cardiometabolic assessment, but prospective studies using imaging-based assessments are required to confirm these findings.

  • Body composition was measured using BIA, which is an indirect method; the authors noted that imaging-based assessments are needed to confirm findings.
  • The study design was case-control, limiting causal inference.
  • The findings suggest visceral fat distribution may provide complementary information beyond general obesity measures in cardiometabolic assessment.
  • The study was conducted among Thai adults, which may limit generalizability to other populations.

What This Means

This research examined the relationship between body fat distribution and high blood pressure (hypertension) in 208 Thai adults, comparing 103 people with normal blood pressure to 105 people with hypertension. The researchers measured various aspects of body composition using a technique called bioelectrical impedance analysis (BIA), which uses small electrical signals to estimate how much fat, muscle, and visceral (belly) fat a person has. They found that people with hypertension tended to be older, more likely to be male, and had higher levels of body fat across multiple measures including body weight, BMI, body fat percentage, fat mass, visceral fat, and waist-to-hip ratio. The most important finding was that visceral fat — the fat stored deep inside the abdomen around internal organs — was independently linked to hypertension even after accounting for age, sex, and skeletal muscle mass. Specifically, each one-unit increase in visceral fat level was associated with a 16% increase in the odds of having hypertension. In contrast, the amount of skeletal muscle a person had was not independently associated with hypertension in the same analysis. The statistical model that included age, sex, and visceral fat level showed reasonable ability to distinguish between hypertensive and normotensive individuals (AUC = 0.79). This research suggests that where fat is stored in the body — particularly visceral or abdominal fat — may matter more for blood pressure risk than overall body fatness alone. Measuring visceral fat could potentially offer useful additional information when assessing a person's cardiovascular health risks. However, the authors caution that this was a case-control study using an indirect fat measurement tool, so future studies using more precise imaging methods and following people over time are needed to confirm whether visceral fat accumulation actually causes hypertension.

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Citation

Srikaew P, Buddhisa S, Satthakarn S, Prakobkaew N, Padkao T, Boonla O, et al.. (2026). Visceral Adiposity Is Independently Associated with Hypertension in Thai Adults: A Case-Control Study.. International journal of environmental research and public health. https://doi.org/10.3390/ijerph23081057