Abstract
BACKGROUND: Hypertension is a major global health issue with increasing prevalence, particularly in China. It is closely linked to obesity, which is a key risk factor for hypertension through mechanisms such as insulin resistance and inflammation. However, research on the relationship between obesity and hypertension in Northwestern China, particularly among diverse ethnic populations, remains limited. METHODS: A cross-sectional study involving 6,186 adults from 10 ethnic groups was conducted between 2018 and 2023 in Gansu, Qinghai, and Inner Mongolia. Anthropometric data, including BMI, WC, BFP, and VFL, were collected. Hypertension was diagnosed on the basis of blood pressure measurements or prior diagnosis. Poisson regression and logistic regression models were used to analyse associations between obesity and hypertension, accounting for ethnic and demographic factors. RESULTS: Statistically significant differences in obesity-related indicators were observed among ethnic groups. The composite obesity group presented the highest hypertension prevalence (65.5%), followed by the central obesity group (60.8%), generalized obesity group (43.2%), and non-obese group (35.5%). All obesity-related indicators (BMI, WC, VFL, and BFP) were positively associated with the odds of hypertension, with BFP demonstrating the strongest effect. RCS analysis revealed a linear association of WC and BFP with hypertension and a nonlinear association of BMI and VFL with hypertension. CONCLUSIONS: In conclusion, our study demonstrates that composite obesity is a more effective indicator for hypertension than other phenotypes. The significant ethnic variations observed underscore the necessity of incorporating ethnic heterogeneity into future prevention strategies and screening protocols, utilizing indicators such as BMI, WC, VFL, and BFP.