Yang G, Shu X O, Gao Y T, Zhang X, Li H, Zheng W
Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center and Vanderbilt University School of Medicine, Nashville, TN 37203, USA.
Int J Obes (Lond). 2007 Dec;31(12):1818-25. doi: 10.1038/sj.ijo.0803680. Epub 2007 Jul 24.
Individuals with prehypertension, a new blood pressure category defined as systolic blood pressure of 120-139 mm Hg and/or diastolic blood pressure of 80-89 mm Hg, are at an increased risk for heart diseases and are strongly recommended to practice lifestyle changes, including weight control. Data on impacts of long-term weight change on prehypertension are sparse.
To evaluate the association between weight change since age 20 and prehypertension risk.
In this cross-sectional analysis of 36 075 non-hypertensive women aged 40-70 years, information on weight history was collected at enrollment in the Shanghai Women's Health Study; blood pressures were measured 2-3 years later by medical professionals. The odds ratios (ORs) of prehypertension were calculated for women who gained or lost weight since age 20 compared with those with stable weight (gain or loss <5 kg), adjusting for age, lifestyle factors, sodium intake and body mass index at age 20.
A total of 47% of the study participants (n=16 981) had prehypertension. For a 6- to 10-kg gain, the OR (95% CI) was 1.36 (1.28-1.45); for 11- to 15-kg gain, 1.64 (1.54-1.75); for 16- to 20-kg gain, 2.32 (2.14-2.51); for 21- to 25-kg gain, 2.91 (2.60-3.26); and for a gain >25 kg; 3.65 (3.13-4.26). While for a 6- to 10-kg loss and a loss >10 kg, the respective ORs were 0.76 (0.67-0.87) and 0.47 (0.38-0.59). The increase in prehypertension risk associated with each 1-kg gain was similar to that associated with a 1-year increase in age. Although weight gain during early adulthood appeared to have a more pronounced effect on the risk of prehypertension, weight gain later in life also contributed significantly to an elevated risk.
Weight gain since age 20 substantially increases risk for prehypertension in non-hypertensive individuals, while weight loss significantly lowers the risk, emphasizing the importance of weight control throughout adulthood in preventing hypertension.
高血压前期是一种新的血压类别，定义为收缩压120 - 139毫米汞柱和/或舒张压80 - 89毫米汞柱，这类人群患心脏病的风险增加，强烈建议改变生活方式，包括控制体重。关于长期体重变化对高血压前期影响的数据很少。
评估20岁以来的体重变化与高血压前期风险之间的关联。
在这项对36075名40 - 70岁非高血压女性的横断面分析中，在上海女性健康研究入组时收集体重史信息；2 - 3年后由医学专业人员测量血压。计算20岁以来体重增加或减少的女性与体重稳定（增减<5千克）的女性相比患高血压前期的比值比（OR），并对年龄、生活方式因素、钠摄入量和20岁时的体重指数进行调整。
共有47%的研究参与者（n = 16981）患有高血压前期。体重增加6至10千克，OR（95%CI）为1.36（1.28 - 1.45）；增加11至15千克，为1.64（1.54 - 1.75）；增加16至20千克，为2.32（2.14 - 2.51）；增加21至25千克，为2.91（2.60 - 3.26）；增加>25千克，为3.65（3.13 - 4.26）。而体重减少6至10千克和减少>10千克时，相应的OR分别为0.76（0.67 - 0.87）和0.47（0.38 - 0.59）。与每增加1千克体重相关的高血压前期风险增加幅度与年龄每增加1岁相关的幅度相似。尽管成年早期体重增加对高血压前期风险的影响似乎更明显，但成年后期体重增加也显著增加了风险。
20岁以来体重增加会大幅增加非高血压个体患高血压前期的风险，而体重减轻则会显著降低风险，这强调了成年期全程控制体重对预防高血压的重要性。
