Atieh Mirzababaei - Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Hadis Mozafari - Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Sakineh Shab-bidar - Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Alireza Milajerdi - Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Background and Aim: Risk of hypertension is inconsistent in the normal-weight, overweight, and obese subjects due to different metabolic phenotypes. We performed a meta-analysis to assess the impact of body mass index (BMI) and metabolic status on risk of incident hypertension. Methods: Data from relevant studies were identified by systematically searching PubMed, Scopus databases up to 20 March 2018 and were analyzed using a random-effects model. 8 prospective studies were archived in the analyses with metabolically healthy normal weight (MHNW) as the reference. Pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated using random-effects or fixed-effect models when appropriate.Results: Overall of 79090 participants of studies, demonstrate that risk of hypertension in metabolically unhealthy obese (MUHO) phenotype was 1.26 fold metabolically healthy obese phenotype (MHO) (OR=1.95, 95%CI: 1.87-2.04, P=0.0001 vs pooled effect size: 1.54, 95%CI: 1.48-1.61, P=0.0001) respectively. Also, significant positive association of metabolically unhealthy normal weight (MUHNW) phenotype and risk of hypertension (OR=1.48, 95%CI: 1.41-1.55, P=0.0001). Metabolically unhealthy overweight (MUHOW) and metabolically healthy overweight (MHOW) phenotypes 50% and 18% increased risk of hypertension compared with the MHNW phenotype (OR=1.50, 95%CI: 1.13-1.71, P=0.0001 and OR=1.18, 95%CI: 1.11-1.27, P=0.0001). Conclusion: This meta-analysis revealed that individuals with metabolic abnormality have a higher risk for hypertension diseases .We are refuting the notion that overweight and obesity without metabolic abnormalities are benign conditions in all population.

BMI, Obesity, Metabolic healthy, Metabolic unhealthy, Metabolic syndrome, Hypertension, Risk