Rosenberg L, Palmer J R, Adams-Campbell L L, Rao R S
Slone Epidemiology Unit, Boston University School of Medicine, Brookline, MA 02446, USA.
J Hum Hypertens. 1999 Apr;13(4):237-41. doi: 10.1038/sj.jhh.1000798.
It is established that obesity is an important risk factor for hypertension, but there is little information on this relationship among highly educated black women. We assessed the relationship of body mass index (weight (kg)/height2 (m)) to prevalent hypertension among US black women who had completed college, and among less educated women as well. The data were collected in 1995 in the Black Women's Health Study: 64530 African-American women aged 21 to 69 years enrolled by completing mailed health questionnaires; 44% of the participants had completed college. We compared the 9394 participants who reported a diagnosis of hypertension treated with a diuretic or antihypertensive drug (cases) with 9259 participants of similar ages who did not have hypertension (controls). Multivariate odds ratios were estimated by logistic regression. The odds ratio for treated hypertension increased with increasing body mass index at every educational level. Among college-educated women, the odds ratio for hypertension was 2.7 for overweight women (index 27.3-32.3) and 4.9 for severely overweight women (index > or =32.3), relative to women with a body mass index <22.8. The prevalences of obesity and hypertension were high among the college-educated women, although not as high as among women with fewer years of education. About a quarter of the difference in the prevalence of hypertension across educational levels was explained by the difference in the proportions who were overweight or severely overweight. These results document a high prevalence of obesity and hypertension, and a strong association of obesity with hypertension, among highly educated US black women.
已证实肥胖是高血压的一个重要危险因素，但关于高学历黑人女性中这种关系的信息却很少。我们评估了体重指数（体重（千克）/身高²（米））与已完成大学学业的美国黑人女性以及受教育程度较低的女性中高血压患病率之间的关系。数据于1995年在黑人女性健康研究中收集：64530名年龄在21至69岁的非裔美国女性通过填写邮寄的健康问卷参与研究；44%的参与者完成了大学学业。我们将9394名报告诊断为高血压且正在使用利尿剂或抗高血压药物治疗的参与者（病例组）与9259名年龄相仿但没有高血压的参与者（对照组）进行了比较。通过逻辑回归估计多变量优势比。在每个教育水平上，治疗高血压的优势比都随着体重指数的增加而升高。在受过大学教育的女性中，相对于体重指数<22.8的女性，超重女性（指数27.3 - 32.3）患高血压的优势比为2.7，重度超重女性（指数≥32.3）患高血压的优势比为4.9。在受过大学教育的女性中，肥胖和高血压的患病率较高，尽管不如受教育年限较少的女性高。不同教育水平之间高血压患病率差异的约四分之一可由超重或重度超重比例的差异来解释。这些结果表明，在美国高学历黑人女性中，肥胖和高血压的患病率很高，且肥胖与高血压之间存在很强的关联。
