The Interdependence of Blood Pressure and Glucose in Vietnam

Tran Thi Thu Nga, Christopher Leigh Blizzard, Luong Ngoc Khue, Truong Le Van Ngoc, Tran Quoc Bao, Petr Otahal, Mark R. Nelson, Costan G. Magnussen, Bui Van Tan, Velandai Srikanth, Au Bich Thuy, Ha Thai Son, Phung Ngoc Hai, Tran Hoang Mai, Michele Callisaya, Seana Gall

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)


Introduction: Modelling of associations of systolic blood pressure (BP) and blood glucose (BG) with their explanatory factors in separate regressions treats them as having independent biological mechanisms. This can lead to statistical inferences that are unreliable because the substantial overlap in their etiologic and disease mechanisms is ignored. Aim: This study aimed to examine the relationship of systolic blood pressure (BP) and blood glucose (BG) with measures of obesity and central fat distribution and other factors whilst taking account of the inter-dependence between them. Methods: Participants (n = 14706, 53.5 % females) aged 25–64 years were selected by multi-stage stratified cluster sampling from eight provinces each representing one of the eight geographical regions of Vietnam. Measurements were made using the World Health Organization STEPS protocols. Results: Structural modelling identified direct effects for BG (men P = 0.000, women P = 0.029), age (men P = 0.000, women P = 0.000) and body mass index (BMI) (men P = 0.000, women P = 0.000) in the estimation of systolic BP, and for systolic BP (men P = 0.036, women P = 0.000) and waist circumference (WC) (men P = 0.032, women P = 0.009) in the estimation of BG. There were indirect effects of age, cholesterol, physical activity and tobacco smoking via their influence on WC and BMI. The errors in estimation of systolic BP and BG were correlated (men P = 0.000, women P = 0.004), the stability indices (men 0.466, women 0.495) showed the non-recursive models were stable, and the proportion of variance explained was mid-range (men 0.553, women 0.579). Conclusion: This study provided statistical evidence of a feedback loop between systolic BP and BG. BMI and WC were confirmed to be their primary explanatory factors. Saturated fat intake and physical activity were identified as possible targets of intervention for overweight and obesity, and indirectly for reducing systolic BP and BG. Harmful/hazardous alcohol intake was identified as a target of intervention for systolic BP.

Original languageEnglish
Pages (from-to)141-150
Number of pages10
JournalHigh Blood Pressure & Cardiovascular Prevention
Issue number2
Publication statusPublished - Mar 2021


  • Blood glucose
  • Blood pressure
  • Inter-relationship

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