Objective  To explore effects of body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist to height ratio (WHtR) on hypertension incidence among adult community population.

  Methods  During April 1999 in Jiangsu province, a baseline survey was conducted among 8 865 residents aged 35 – 74 years in three urban communities and nine natural villages and then two follow-up studies were carried out among 4 582 and 3 847 residents 2 and 5 years after the baseline survey. Finally, physical examination and questionnaire interview were performed among 2 531 residents being followed-up 2 or 5 years later and without hypertension, diabetes, cardiovascular diseases and high fasting blood glucose (≥ 5.6 mmol/L) at the baseline survey. Multivariate Cox proportional hazard regression analysis was adopted to analyze the effects of WC, BMI, WHR and WHtR on hypertension incidence.

  Results  Among the 2 531 participants with a median follow-up interval of 3.8 years, 469 new hypertension were diagnosed by the end of follow-up and the hypertension incidence rate was 18.53%. After adjusting for gender, age, education, occupation, family annual income per capita, smoking and alcohol drinking, significantly higher hypertension risks were estimated for the participants with the third and the highest quartile value of BMI (hazard risk HR = 1.46 and 2.42), WC (HR = 1.63 and 2.51), WHR (HR = 1.70 and 2.62), and WHtR (HR = 1.63 and 2.62) compared to the participants with the lowest quartile value of the four indicators, respectively; furthermore, the hypertension risk was significantly higher for the participants with the highest tertile value of BMI and the second or the highest tertile values of WC (HR = 1.86 and 2.55) in comparison with the participants with the lowest tertile value of BMI and WC.

  Conclusion  High somatotype indexes including WC, BMI, WHR and WHtR are associated with increased risk of hypertension incidence among adult community residents.