Redón Josep, Cea-Calvo Luis, Moreno Basilio, Monereo Susana, Gil-Guillén Vicente, Lozano José V, Martí-Canales Juan C, Llisterri José L, Aznar Jose, Fernández-Pérez Cristina
Hypertension Clinic, Hospital Clínico, University of Valencia, and CIBER of Obesity and Nutrition (CB 03/06), Carlos III Institute of Health, Madrid, Spain.
J Hypertens. 2008 Sep;26(9):1757-64. doi: 10.1097/HJH.0b013e3283077f03.
Studies on the impact of weight excess and fat distribution on blood pressure are usually limited to young and middle-aged population, and data on the elderly are scarce.
We performed an analysis of the Prevencion de Riesgo de Ictus, a population-based study on individuals aged 60 years or more in Spain, to assess the impact of weight excess, stratified by body mass index (normal <25; overweight 25-29.9; obesity > or =30 kg/m), and waist circumference [increased if > or =88 cm (women) or > or =102 (men)] on the prevalence on hypertension and lack of blood pressure control. In 6263 individuals (mean age 71.9 years old, 53.3% women; 73.0% with diagnosed hypertension), prevalence of obesity was 35.0%, and 65.6% showed an increased waist circumference. Body mass index and waist circumference showed an independent impact on the prevalence and absence of hypertension control. In a multivariate model including age, sex, body mass index, and waist circumference, prevalence of hypertension was higher in the overweight and obesity groups (odds ratio 1.41 and 1.96, respectively, compared to normal weight), and in those with increased waist circumference (odds ratio 1.25) compared with normal waist circumference. After further adjustment for antihypertensive therapy, overweight, and obesity (odds ratio 1.40 and 1.59, respectively) as well as increased waist circumference (odds ratio 1.39) were independently related to absence of blood pressure control. The impact of waist circumference on hypertension and blood pressure control was shown in each category of body mass index.
In this cross-sectional study in an elderly population, body mass index and waist circumference showed an independent and direct impact on the prevalence of hypertension and on the absence of blood pressure control.
关于体重超标和脂肪分布对血压影响的研究通常局限于中青年人群，而关于老年人的数据较少。
我们对西班牙一项针对60岁及以上人群的基于人群的“预防卒中风险”研究进行了分析，以评估体重超标（按体重指数分层：正常<25；超重25 - 29.9；肥胖≥30 kg/m²）和腰围[女性≥88 cm或男性≥102 cm则为增加]对高血压患病率和血压控制不佳的影响。在6263名个体中（平均年龄71.9岁，53.3%为女性；73.0%已诊断为高血压），肥胖患病率为35.0%，65.6%的人腰围增加。体重指数和腰围对高血压患病率及血压控制不佳均有独立影响。在一个包括年龄、性别、体重指数和腰围的多变量模型中，超重和肥胖组的高血压患病率更高（与正常体重相比，比值比分别为1.41和1.96），腰围增加者与正常腰围者相比高血压患病率更高（比值比为1.25）。在进一步调整抗高血压治疗、超重和肥胖因素后，超重和肥胖（比值比分别为1.40和1.59）以及腰围增加（比值比为1.39）与血压控制不佳独立相关。腰围对高血压和血压控制的影响在每个体重指数类别中均有体现。
在这项针对老年人群的横断面研究中，体重指数和腰围对高血压患病率及血压控制不佳具有独立且直接的影响。
