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However, studies examining these relationships are often from high income countries, thus the results may not be generalizable to low and middle-income countries (LMIC), such as India.

In spite of the need for studies investigating the associations between risk factors for hypertension, there is limited reliable evidence from India and other LMICs.

A main determinant of blood pressure is adiposity [8–10], and various mechanisms have been proposed to link different body fat distributions to blood pressure and risk of hypertension [9, 10].

However, despite the suggested mechanisms, there are uncertainties surrounding whether a general or central distribution of adiposity is more strongly associated with blood pressure.

Additionally, by improving our understanding of whether a simple measure of general or central adiposity is more strongly associated with blood pressure and hypertension may help focus screening efforts and risk stratification of clinical populations where the measurement of blood pressure is not feasible.

However, most previous studies from India are small, from one region, provide conflicting evidence, and do not fully investigate the effect of age and sex on these relationships [11–14].

We adjusted all analyses for education and location, with further adjustments, variously, for either a measure of central (waist circumference) or general (body mass index) adiposity.

In order to aid in the characterization of disease and death of individuals, households and communities, the Centre for Global Health Research health check-up survey of the general population of India was conducted during 20.

Participants were recruited in four states (Andhra Pradesh, Karnataka, Gujarat, Rajasthan) and two union territories (Chandigarh, Delhi) from randomly selected sampling units (within the Registrar General of India’s “Sample Registration System”), which were based on the 1991 census [15].

Indeed, there is a paucity of research from India that directly examines the association of commonly used anthropometric measures of adiposity with blood pressure and hypertension.

Thus, these associations remain inadequately characterized. Furthermore, given the importance and potential differences in prognostic value of distinct blood pressure components [systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, mean arterial pressure, mid-blood pressure] [4, 5], it is equally important to elucidate the relationships between anthropometric measures and continuous blood pressure components, in addition to hypertension.

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