Objective  To examine associations of body mass index (BMI) and waist circumference (WC) with H-type hypertension (hypertension with elevated plasma homocysteine) in adult residents in Hunan province and to provide evidences for early intervention and community prevention of the disease.

  Methods  We carried out a questionnaire interview, physical examination and laboratory test among 4 012 residents aged 30 years and above selected with multi-stage random cluster sampling in 6 municipal regions in Hunan province from June 2013 to May 2014.

  Results  Among the participants, the number (ratio) of underweight, normal weight, overweight, and obesity were 218 (5.4%), 2 210 (55.1%), 1 241 (30.9%), and 343 (8.5%), respectively. The prevalence rate of H-type hypertension in the underweight, normal weight, overweight and obesity participants was 12.39%, 15.57%, 23.93%, and 35.57% and the rate were 12.82% and 23.85% among the participants with non-central and central obesity, respectively. The prevalence rate of H-type hypertension differed significantly by BMI and WC among the participants (both P < 0.05). After adjusting for confounding factors such as gender, age, education, marital status, smoking, and alcohol drinking, multivariate unconditional logistic regression analysis revealed following risk factors for H-type hypertension: overweight (odds ratio OR = 1.783, 95% confidence interval 95% CI: 1.486 – 2.140), obesity ( OR = 3.256, 95% CI: 2.505 – 4.233), and central obesity (OR = 2.198, 95% CI: 1.829 – 2.641); while, underweight was a protective factor against H-type hypertension (OR = 0.547, 95% CI: 0.352 – 0.851).

  Conclusion  BMI and WC are related to H-type hypertension among community adult residents in Hunan province.