To determine the correlation between weight-adjusted-waist index (WWI) with prehypertension and hypertension in the general population. This cross-sectional study was conducted from September 13, 2023 to November 30, 2023 and included 4885 permanent residents in Zhejiang Province. The association between WWI with prehypertension and hypertension was carefully evaluated using logistic regression models and penalized spline functions. The category-free analysis was performed to corroborate whether WWI enhanced the ability to estimate prehypertension and hypertension. Multivariable logistic regression indicated that after adjustment for conventional risk factors, each standard deviation increase in WWI levels was associated with a 29% and 50% increased risk of prehypertension (hazard ratio, 1.29; 95% confidence interval, 1.14-1.45) and hypertension (1.50; 1.34-1.68), respectively. Referring to the participants in the lowest quartile of WWI, those in the highest quartile had a significantly increased risk of prehypertension (1.64; 1.17-2.30) and hypertension (2.47; 1.80-3.39). Smoothing curve fitting and trend logistic regression suggested a linear positive correlation, and the robustness of these findings was observed in interaction tests and subgroup analyses. The category-free analysis suggested that adding WWI levels to the traditional model ultimately improved the predictive ability of prehypertension and hypertension. The results of this study confirmed the significant correlation between WWI with prehypertension and hypertension, independent of conventional risk factors. More importantly, these findings suggested the potential usefulness of WWI levels to improve the risk stratification of hypertension and prehypertension.
Zhu et al. (2026) studied this question.