Wilsgaard T, Schirmer H, Arnesen E
Institute of Community Medicine, University of Tromso, N-9037 Tromso, Norway.
Arch Intern Med. 2000 Oct 9;160(18):2847-53. doi: 10.1001/archinte.160.18.2847.
The prevalence of obesity and hypertension is increasing in Western societies. We examined the effects of initial body mass index ([BMI] weight in kilograms divided by height in meters squared) and change in BMI on change in blood pressure, and we assessed sex differences.
A general population in the municipality of Tromso, northern Norway, was examined in 1986 and 1987 and again in 1994 and 1995. Altogether, 75% of the individuals, women aged 20 to 56 years and men aged 20 to 61 years, attended the baseline examination. A total of 15,624 individuals (87% of all still living in the municipality) were examined twice.
Mean BMI increased between the examinations, more for the younger than the older examinees, and also more among women than men (P<.001). Adjusted for several covariates, BMI change was associated with systolic and diastolic blood pressure change for both sexes (regression coefficients: 1.43 [95% confidence interval (CI), 1.23-1. 64] and 0.90 [95% CI, 0.76-1.04], respectively, for men; and 1.24 [95% CI, 1.09-1.39] and 0.74 [95% CI, 0.63-0.84] for women). Baseline BMI was associated with systolic and diastolic blood pressure change for women only (regression coefficients: 0.38 [95% CI, 0.30-0.47] and 0.17 [95% CI, 0.11-0.23], respectively).
For women, both BMI at baseline and BMI change were independently associated with blood pressure change. For a given increase in BMI, obese women had a greater increase in blood pressure than lean women. This was not the case for men, for whom BMI change was the only significant predictor. Furthermore, a BMI increase for obese women induced a greater systolic blood pressure increase compared with men.
在西方社会，肥胖和高血压的患病率正在上升。我们研究了初始体重指数（BMI，体重千克数除以身高米数的平方）及BMI变化对血压变化的影响，并评估了性别差异。
对挪威北部特罗姆瑟市的普通人群于1986年和1987年进行了检查，并于1994年和1995年再次检查。共有75%的个体（年龄在20至56岁的女性和20至61岁的男性）参加了基线检查。总共15624名个体（占所有仍居住在该市人口的87%）接受了两次检查。
两次检查之间平均BMI有所增加，年轻受检者的增加幅度大于年长受检者，女性的增加幅度也大于男性（P<0.001）。在对多个协变量进行校正后，BMI变化与男女两性的收缩压和舒张压变化均相关（男性的回归系数分别为1.43[95%置信区间（CI），1.23 - 1.64]和0.90[95%CI，0.76 - 1.04]；女性的回归系数分别为1.24[95%CI，1.09 - 1.39]和0.74[95%CI，0.63 - 0.84]）。仅基线BMI与女性的收缩压和舒张压变化相关（回归系数分别为0.38[95%CI，0.30 - 0.47]和0.17[95%CI，0.11 - 0.23]）。
对于女性，基线BMI和BMI变化均与血压变化独立相关。对于给定的BMI增加量，肥胖女性的血压升高幅度大于瘦女性。男性并非如此，BMI变化是男性唯一显著的预测因素。此外，与男性相比，肥胖女性BMI增加引起的收缩压升高幅度更大。
