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Background  There have been few studies on the association between the incidence of hypertension and the presence and distribution of body fat. The aim of this article was to evaluate this association.    Methods and Results  Data were obtained from the China Health Nutrition Survey, a 22‐year cohort study of 12 907 participants. Body mass index and triceps skinfold thickness were used as markers of body fat, whereas waist circumference ( WC ) was used as a marker of fat distribution. Cox regression was used to examine the association of body mass index,  WC , and skinfold thickness with the incidence of hypertension. The interval between the baseline and hypertension diagnosis was the time variable, and hypertension was the end event. The mean age and proportion of men and women were 38.29 and 38.03 years and 45.63% and 54.37%, respectively. Compared with normal  WC , abdominal obesity was associated with hypertension ( P <0.001; crude hazard ratio, 2.11; 95% confidence interval, 1.89–2.37). Similarly, overweight (crude hazard ratio, 1.75; 95% confidence interval, 1.64–1.87) and obesity (crude hazard ratio, 3.19; 95% confidence interval, 2.80–3.63) were risk factors for hypertension (all  P <0.001). When stratified by sex, the results confirmed that  WC  and body mass index predicted the development of hypertension in both men and women but not skinfold thickness in women.    Conclusions  Body mass index and  WC  were independent risk factors for hypertension, but skinfold thickness was a poor marker of body fat and could not be used to predict hypertension.

Association of Body Fat Mass and Fat Distribution With the Incidence of Hypertension in a Population‐Based Chinese Cohort: A 22‐Year Follow‐Up