Waist-to-hip ratio as an index of risk for hyperglycemia among hypertensive patients.

Overview

Participants in a systematic antihypertensive care program were examined to determine whether the site of fat predominance--measured by the waist-to-hip ratio--is related to hyperglycemia in patients taking diuretics. Among 1,044 hypertensive patients meeting a set of selection criteria, 22 men who developed hyperglycemia during a mean treatment period of 25.6 months were identified and individually matched for age, race, body mass index, and duration of diuretic treatment to a comparable group of hypertensive patients who remained normoglycemic. The mean waist-to-hip ratio was higher among the hyperglycemic men, although this difference did not reach conventional levels of statistical significance. However, a significantly greater proportion of the hyperglycemic men than those who were normoglycemic fell into a higher ratio category when waist-to-hip ratios were classified according to whether they were less than or greater than or equal to 0.90. When the ratios were examined in relation to body mass index, the greatest difference between the two groups was observed in the leanest group. This study suggests that the waist-to-hip ratio, in conjunction with total body fatness, may be an important tool for distinguishing persons with hypertension who may develop hyperglycemia when treated with diuretics.