Abstract: Objective To explore the association between waist circumference and new-onset hypertension in the elderly people. Methods A total of 2038 elderly individuals(male/female: 1129/909, aged≥60 years) without hypertension at baseline were collected from the China Health and Retirement Longitudinal Study(CHARLS) 2011-2015. After preprocessing missing covariates via multiple imputation based on 5 replications, we compared baseline characteristics between individuals with new-onset hypertension and those without hypertension. The generalized additive model and SpearmaŃs correlation analysis were used to evaluate the association between waist circumference and baseline blood pressure. Multivariate Cox regression model was used to analyze the effect of waist circumference on new-onset hypertension. Moreover, restricted cubic spline was used to visualize the nonlinear correlation between waist circumference and new-onset hypertension. Results After a mean follow-up of 3.26 years, 717(35.2%) participants presented with hypertension. The generalized additive model and SpearmaŃs rank revealed the significant positive correlation of waist circumference with the baseline systolic and diastolic blood pressure(P<0.001). After adjusting age, sex, alcohol intake, smoking status, body mass index, low density lipoprotein and chronic diseases(diabetes mellitus, heart disease and stroke), the risk of new-onset hypertension increased by 19% with 10 cm increase in waist circumference. After multivariable adjustment, compared with the lowest quantile group, the hazard ratio(HR) of new-onset hypertension was 1.33(95%CI: 1.01-1.75) in the highest quantile group. Restricted cubic spline regression analysis showed that the risk of hypertension increased with the increase of waist circumference. Conclusions This study demonstrates that high waist circumference can be an independent risk factor for new-onset hypertension.

Key words: aged, waist circumference, body mass index, hypertension, obesity