Revisiting Waist Circumference: A Hypertension Risk Factor that Requires a More In-depth Understanding.

As a major cause of various cardiovascular diseases, the prevalence of hypertension has been increasing in the past 30 years, leading to significant socioeconomic and health burdens. Obesity is one of the major risk factors for hypertension. Body mass index (BMI) is the most used anthropometric index to measure obesity in clinical practice and to assess the risk of obesity-related diseases. However, obesity is a heterogeneous disease, and the accumulation of fat in different body regions leads to differences in cardiovascular and metabolic risks. BMI only reflects the overall obesity but does not consider the distribution of fat and muscle mass. The limitation of BMI makes it insufficient to assess the risk of hypertension attributed to obesity. In addition, waist circumference is an easily obtainable anthropometric index to evaluate abdominal fat distribution. High waist circumference is an independent risk factor for various cardiovascular diseases and all-cause mortality regardless of BMI. Preliminary data indicate that waist circumference is significantly associated with the risk of hypertension at different BMI levels. However, routine measurement of waist circumference is currently not required in current clinical guidelines or is only recommended for obese populations, indicating an insufficient understanding of waist circumference. In this review, we summarize the measurement methods and diagnostic thresholds of waist circumference for abdominal obesity, the trend of central obesity prevalence, the superiority of waist circumference over other anthropometric indices, and recent cross-sectional and longitudinal studies on the association between obesity and hypertension.

Ratio of waist circumference to body mass index: A novel predictor of clinical outcome in hypertension patients.

We aim to investigate the influence of waist circumference and body mass index (BMI) on all-cause death and cardiovascular-specific death in patients with hypertension. This prospective cohort study, based on waist circumference and body mass index measurements in patients with hypertension, provided risk estimates of all-cause mortality and cardiovascular events. The waist circumference-to-BMI ratio (WtBR) is an anthropometric measure integrating waist circumference and BMI. We utilized multivariable Cox regression analysis, restricted cubic spline model, Kaplan-Meier plot, random forest analysis, and sensitivity analysis to assess the relationship of WtBR with all-cause mortality. Subsequently, Fine-Gray competing risk regression models were applied to precisely evaluate the probability of cardiovascular-specific death attributed to high WtBR. The results indicate that thea deceased group showed significantly higher WtBR and lower BMI compared with the alive groups (P < .05), while no significant difference was observed in waist circumference (P = .373). When analyzed as continuous, the risk of all-cause death elevated with increasing WtBR in the adjusted model with an HR of 2.42 (95% CI, 2.06-2.85). The restricted cubic spline illustrated an elevated risk of all-cause mortality as WtBR increased (J-shaped curve). Nevertheless, WtBR showed no significant association with cardiovascular-specific death and the prediction model exhibited a reliable performance in the testing set. This study supported that WtBR, an anthropometric measure, is independently associated with all-cause death in hypertensive patients. It's advisable to routinely assess waist circumference in hypertensive patients regardless of BMI, in order to more effectively manage the risk of obesity-related health.

Chemical constituents from rhizomes of Paeonia sinjiangensis / 中草药

Objective: To investigate the chemical constituents from the rhizomes of Paeonia sinjiangensis. Methods: The chemical constituents were isolated and identified by chromatography on silica gel, Sephadex LH-20, ODS, and RP-HPLC. Their structures were elucidated on the basis of physicochemical properties and spectral analyses. Results: Sixteen compounds were isolated from the 80% ethanol extract from the rhizomes of P. sinjiangensis, and identified as 8-debenzoylpaeoniflorin (1), 4-O-butylpaeoniflorin (2), galloylpaeoniflorin (3), 4-O-methylbenzoylpaeoniflorin (4), benzoylalbiflorin (5), albiflorin R1 (6), 9-O-butylpaeonidanin (7), (Z)-(1S, 5R)-β-pinen-10-yl β-vicianoside (8), gallic acid (9), methyl gallate (10), ethyl gallate (11), isovanillic (12), 6-hydroxycoumarin (13), 3, 4, 23-trihydroxy-24, 30-dinorolean-12, 20 (29)-dien-28-oic acid (14), palbinone (15), and cadina-4, 11-dien-14-oic acid (16). Conclusion: Compound 16 is firstly isolated from the Ranunculaceae family, and compounds 1-15 are isolated from this plant for the first time.