Ibaraki Health Plaza, Ibaraki Health Service Association, University of Tsukuba, Ibaraki, Japan.
J Hypertens. 2012 Jun;30(6):1122-8. doi: 10.1097/HJH.0b013e328352b879.
The aim of this study was to examine the association between BMI and risk of incident hypertension among Japanese men and women who are middle-aged and older.
Prospective, population-based cohort study.
A total of 68 205 nonhypertensive adults (18 336 men and 49 869 women) aged 40-79 years who completed health check-ups in the Ibaraki prefecture, Japan, in 1993 were followed up through 2006. To exclude the impact of BMI change during the follow-up period, a time-dependent covariate Cox proportional hazards model was used to compute the hazard ratios of incident hypertension according to BMI categories. Incident hypertension was defined as a SBP of at least 140 mmHg, a diastolic BP of at least 90 mmHg, and/or hypertensive medication use.
A total of 30 982 adults (45.4%) developed hypertension (9331 men and 21 651 women) during a mean of 3.9 years of follow-up. Compared with a BMI of less than 19.0, time-dependent covariates adjusted hazard ratios [95% confidence interval (CI)] for hypertension among participants with a BMI of at least 25.0 were 1.42 (1.17-1.73) for men aged 40-59 years, 1.34 (1.19-1.51) for men aged 60-79 years, 1.47 (1.33-1.62) for women aged 40-59 years, and 1.29 (1.18-1.41) for women aged 60-79 years.
The baseline BMI is associated with future risk for incident hypertension even after accounting for weight change during the follow-up period. Weight loss may be recommended to nonhypertensive obese adults to prevent the development of hypertension.
本研究旨在探讨日本中老年人的 BMI 与高血压发病风险之间的关系。
前瞻性、基于人群的队列研究。
共有 68205 名非高血压成年人（男性 18336 名，女性 49869 名），年龄 40-79 岁，于 1993 年在日本茨城县完成健康检查，随访至 2006 年。为排除随访期间 BMI 变化的影响，采用时间依赖性协变量 Cox 比例风险模型计算根据 BMI 类别计算高血压发病的风险比。高血压定义为收缩压至少 140mmHg，舒张压至少 90mmHg，或使用降压药物。
共有 30982 名成年人（45.4%）在平均 3.9 年的随访期间发生高血压（男性 9331 名，女性 21651 名）。与 BMI<19.0 的患者相比，年龄在 40-59 岁的 BMI 至少为 25.0 的参与者中，高血压的时间依赖性协变量调整后的风险比（95%置信区间）为 1.42（1.17-1.73），60-79 岁的男性为 1.34（1.19-1.51），40-59 岁的女性为 1.47（1.33-1.62），60-79 岁的女性为 1.29（1.18-1.41）。
即使在考虑随访期间体重变化的情况下，基线 BMI 与未来高血压发病风险相关。建议非高血压肥胖成年人减轻体重，以预防高血压的发生。
