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. 2021 Sep 22;13(10):3309.
doi: 10.3390/nu13103309.

Increased Adiposity Appraised with CUN-BAE Is Highly Predictive of Incident Hypertension. The SUN Project

Ligia J Dominguez  1 , Carmen Sayón-Orea  2   3   4 , Alfredo Gea  2   3 , Estefania Toledo  2   3 , Mario Barbagallo  1 , Miguel A Martínez-González  2   3   5
Affiliations

Increased Adiposity Appraised with CUN-BAE Is Highly Predictive of Incident Hypertension. The SUN Project

Ligia J Dominguez et al. Nutrients. .

Abstract

Overweight and obesity are growing worldwide and strongly associated with hypertension. The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index is proposed as an optimal indicator of body fatness. We aimed to investigate the association of body fat as captured by the CUN-BAE index with incident hypertension in a Mediterranean population. We assessed 15,950 participants of the SUN (Seguimiento Universidad de Navarra) prospective cohort (63.7% women) initially free of hypertension. Participants completed follow-up questionnaires biennially. A validated 136-item food-frequency questionnaire was administered at baseline. We used Cox models adjusted for multiple confounders. Among 12.3 years of median follow-up (interquartile range: 8.3, 15.0 years), 2160 participants reported having received a diagnosis of hypertension. We observed a strong direct association between progressively higher the CUN-BAE index at baseline and incident hypertension during follow-up in multivariable-adjusted models for men and women, even after further adjustment for BMI ≥ 30 kg/m2, showing a significant association also in non-obese participants. For each 2-unit increase in the CUN-BAE index, hypertension risk increased by 27% and 29% in men and women, respectively. The results remained significant when considering longitudinal repeated measures of changes in body fat assessed with the CUN-BAE index among the different biennial follow-up questionnaires. Our results emphasize the importance of reducing and maintaining a low body fat to prevent hypertension.

Keywords: CUN-BAE; adiposity; blood pressure; body fat; cohort studies; diet; hypertension; obesity; overweight.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow-chart of participants of the SUN project to be included in the present analyses.
Figure 2
Figure 2
Cumulative incidence of hypertension during follow-up for the lower quartile (Q1), the second and third quartiles combined (Q2–Q3), and the fourth quartile (Q4) of body fat as captured by the CUN-BAE index after adjustment for potential confounders among men and women in the SUN (“Seguimiento Universidad de Navarra”) cohort, 1999–2019.
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