Is. Okosun et al., Apolipoprotein B, ratio of total cholesterol to HDL-C, and blood pressure in abdominally obese white and black American women, J HUM HYPER, 15(5), 2001, pp. 299-305
Objective: To compare the association of apolipoprotein a (ApoB) and total
cholesterol to high-density lipoprotein cholesterol (TC/HDL) with blood pre
ssure in abdominally obese white and black American women. We also sought t
o determine if there are ethnic differences in blood pressure values that c
ould be explained by differences in mean values of ApoB and TC/HDL,
Methods: Data (n = 1844) from the Third US National Health and Nutrition Ex
amination Survey were used in this study. Abdominal obesity was defined as
waist circumference (WC) of greater than or equal to 88 cm or having WC gre
ater than what was expected as predicted from residuals obtained from linea
r regression of WC on BMI, Bi-variate Pearson's correlation analysis was us
ed to quantify the degree of association of ApoB and TC/HDL with blood pres
sure and other lipids. Multiple linear regression analysis was used to asse
ss the independent contribution of ApoB and TC/HDL to blood pressure, adjus
ting for age, total cholesterol, alcohol intake, and smoking. To determine
ethnic differences in blood pressure values associated with ApoB or TC/HDL,
dummy variables were used to compare blacks with whites fitted in multiple
regression models, while adjusting for age, total cholesterol, alcohol int
ake and smoking.
Results: Elevated ApoB was positively associated with diastolic and systoli
c blood pressure (DBP/SBP) in blacks and whites, independent of age, total
cholesterol, alcohol intake and smoking (P < 0.01). Elevated TC/HDL was als
o positively associated with increased DBP and SEP in whites (P < 0.05), Fo
r the same value of ApoB and TC/HDL whites had higher values of DBP and SEP
than blacks, adjusting for confounding variables.
Conclusions: Compared with TC/HDL, ApoB was more strongly associated with D
BP and SEP in both abdominally obese white and black women. Since ApoB is a
ssociated with hypertension, the combination of elevated ApoB and hypertens
ion may identify a group of patients with more marked risk of vascular dise
ase, thus, warranting further investigation.