State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
PLoS One. 2013 Aug 13;8(8):e71223. doi: 10.1371/journal.pone.0071223. eCollection 2013.
Most studies have suggested that elevated body mass index (BMI) was associated with the risk of death from all cause and from specific causes. However, there was little evidence illustrating the effect of BMI on the mortality in elderly hypertensive patients in Chinese population.
The information of 10,957 hypertensive patients at baseline not less than 60 years were from Xinzhuang, a town in Minhang district of Shanghai, was extracted from the Electronic Health Record (EHR) system. All study participants were divided into eight categories of baseline BMI (with cut-points at 18, 20, 22, 24, 26, 28 and 30 kg/m(2)). Relative hazard ratio of death from all cause, cardiovascular and non-cardiovascular cause by baseline BMI groups were calculated, standardized for sex, age, smoking, drinking, physical activity, systolic blood pressure, history of cardiovascular disorders, serum lipid disturbance, diabetes mellitus and antihypertensive drug treatment.
DURING FOLLOW UP (MEDIAN: 3.7 years), 561 deaths occurred. Underweight (BMI<18 kg/m(2)) was associated with significantly increased mortality from all cause mortality (OR: 2.00; 95% CI: 1.43-2.79) and non cardiovascular mortality (OR: 2.76; 95% CI: 1.87-4.07), but not with cardiovascular mortality. For the cause specific analysis, the underweight was associated significantly with neoplasms (OR: 2.15; 95% CI: 1.16-4.00) and respiratory disorders (OR: 3.41; 95% CI: 1.64-7.06). The results for total mortality and specific cause mortality were not influenced by sex, age and smoking status.
Our study revealed an association between underweight and increased mortality from non-cardiovascular disorders in elderly hypertensive patients in Chinese community. Overweight and obesity were not associated with all cause or cause specific death.
大多数研究表明，体重指数（BMI）升高与全因死亡和特定原因死亡的风险相关。然而，几乎没有证据表明 BMI 对中国老年高血压患者的死亡率有影响。
从上海市闵行区莘庄镇的电子健康记录（EHR）系统中提取了基线时年龄不小于 60 岁的 10957 名高血压患者的信息。所有研究参与者均分为 8 组基线 BMI（切点为 18、20、22、24、26、28 和 30 kg/m2）。按性别、年龄、吸烟、饮酒、体力活动、收缩压、心血管疾病史、血脂紊乱、糖尿病和降压药物治疗情况对全因死亡、心血管原因和非心血管原因的相对危险比进行了计算。
在随访期间（中位数：3.7 年），有 561 人死亡。体重过轻（BMI<18 kg/m2）与全因死亡率（OR：2.00；95%CI：1.43-2.79）和非心血管死亡率（OR：2.76；95%CI：1.87-4.07）显著升高相关，但与心血管死亡率无关。对于病因特异性分析，体重过轻与肿瘤（OR：2.15；95%CI：1.16-4.00）和呼吸系统疾病（OR：3.41；95%CI：1.64-7.06）显著相关。性别、年龄和吸烟状况对总死亡率和特定病因死亡率没有影响。
本研究揭示了中国社区老年高血压患者体重过轻与非心血管疾病死亡率升高之间存在关联。超重和肥胖与全因或病因特异性死亡无关。
