Skip to main content
    • Aa
    • Aa

Generalised and abdominal obesity and risk of diabetes, hypertension and hypertension–diabetes co-morbidity in England

  • Vasant Hirani (a1), Paola Zaninotto (a1) and Paola Primatesta (a1)

To look at trends in generalised (body mass index (BMI) ≥30 kg m–2) and abdominal (waist circumference (WC) >102 cm in men, >88 cm in women) obesity among adults between 1993 and 2003, and to evaluate their association with diabetes, hypertension and hypertension–diabetes co-morbidity (HDC) in England.


Analyses of nationally representative cross-sectional population surveys, the Health Survey for England (HSE).


Non-institutionalised men and women aged ≥35 years.


Interviewer-administered questionnaire (sociodemographic information, risk factors, doctor-diagnosed diabetes), measurements of height and weight to calculate BMI. WC and blood pressure measurements were taken by trained nurses.


Generalised obesity increased among men from 15.8% in 1993 to 26.3% in 2003, and among women from 19.3% to 25.8%. Abdominal obesity also increased in both sexes (men: 26.2% in 1993 to 39.0% in 2003; women: 32.4% to 47.0%). In 1994, 1998 and 2003, generalised and abdominal obesity were independently associated with risk of hypertension, diabetes and HDC. The odds of diabetes associated with generalised obesity in 1994, 1998 and 2003 were 1.62, 2.26 and 2.62, respectively, in women and 1.24, 1.82 and 2.10, respectively, in men. Similar differences were observed for hypertension and HDC. Men and women with abdominal obesity also showed a higher risk for diabetes, hypertension and HDC than those with a normal WC.


If current trends in obesity continue then the risk of related morbidities may also increase. This will impact on cardiovascular disease morbidity and mortality, with cost implications for the health service. Therefore there is an urgent need to control the epidemic of obesity.

Corresponding author
Corresponding author: Email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

5 IS Okosun , KM Chandra , S Choi , J Christman , GE Dever , TE Prewitt . Hypertension and type 2 diabetes co-morbidity in adults in the United States: risk of overall and regional adiposity. Obesity Research 2001; 9: 19.

6 MR Weir . Diabetes and hypertension: blood pressure control and consequences. American Journal of Hypertension 1999; 12: 170S178S.

7 Z Huang , WC Willett , JE Manson , B Rosner , MJ Stampfer , FE Speizer , Body weight, weight change, and risk for hypertension in women. Annals of Internal Medicine 1998; 128: 8188.

8 M Epstein , JR Sowers . Diabetes mellitus and hypertension. Hypertension 1992; 19: 403418.

12 KS Stamatelopoulos , JP Lekakis , G Vamvakou , P Katsichti , A Protogerou , I Revela , The relative impact of different measures of adiposity on markers of early atherosclerosis. International Journal of Cardiology 2007; 119: 139146.

14 RH Eckel , SM Grundy , PZ Zimmet . The metabolic syndrome. Lancet 2005; 365: 14151428.

18 S Rossner . Obesity: the disease of the twenty-first century. International Journal of Obesity and Related Metabolic Disorders 2002; 26 (Suppl. 4): S24.

19 SP Walker , EB Rimm , A Ascherio , I Kawachi , MJ Stampfer , WC Willett . Body size and fat distribution as predictors of stroke among US men. American Journal of Epidemiology 1996; 144: 11431150.

20 A Molarius , JC Seidell . Selection of anthropometric indicators for classification of abdominal fatness – a critical review. International Journal of Obesity and Related Metabolic Disorders 1998; 22: 719727.

22 MM Harris , J Stevens , N Thomas , P Schreiner , AR Folsom . Associations of fat distribution and obesity with hypertension in a bi-ethnic population: the ARIC study. Atherosclerosis Risk in Communities Study. Obesity Research 2000; 8: 516524.

23 AN Faria , FF Ribeiro Filho , SR Gouveia Ferreira , MT Zanella . Impact of visceral fat on blood pressure and insulin sensitivity in hypertensive obese women. Obesity Research 2002; 10: 12031206.

24 D Carey , AB Jenkins , LV Campbell , J Freund , DJ Chisholm . Abdominal fat and insulin resistance in normal and overweight women: direct measures reveal a strong relationship in subjects at both low and high risk of NIDDM. Diabetes 1996; 45: 633638.

25 H Kanai , Y Matsuzawa , K Kotani , Y Keno , T Kobatake , Y Nagai , Close correlation of intra-abdominal fat accumulation to hypertension in obese women. Hypertension 1990; 16: 484490.

26 JE Manson , WC Willett , MJ Stampfer , GA Colditz , DJ Hunter , SE Hankinson , Body weight and mortality among women. New England Journal of Medicine 1995; 333: 677685.

27 A Siani , FP Cappuccio , G Barba , M Trevisan , E Farinaro , R Lacone , The relationship of waist circumference to blood pressure: the Olivetti Heart Study. American Journal of Hypertension 2002; 15: 780786.

32 FX Pi-Sunyer . Short-term medical benefits and adverse effects of weight loss. Annals of Internal Medicine 1993; 119: 722726.

33 Z Huang , A Reddy . Weight change, ideal weight and hypertension. Current Opinions in Nephrology and Hypertension 1999; 8: 343346.

34 J Staessen , R Fagard , P Lijnen , A Amery . Body weight, sodium intake, and blood pressure. Journal of Hypertension 1989; 7 (Suppl.): S1923.

36 JO Hill , HR Wyatt , GW Reed , JC Peters . Obesity and the environment: where do we go from here? Science 2003; 299: 853855.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 3
Total number of PDF views: 12 *
Loading metrics...

Abstract views

Total abstract views: 74 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th June 2017. This data will be updated every 24 hours.