Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Biostatistics, Biomedicine & Health Sciences, Catholic University College of Medicine, Seoul, Korea.
J Clin Hypertens (Greenwich). 2018 Oct;20(10):1417-1426. doi: 10.1111/jch.13389.
The presence of abdominal obesity and lack of physical activity are both risk factors for the development of hypertension. The aim of this study was to analyze the risk of developing hypertension according to baseline waist circumference (WC). In total, 16 312 476 non-hypertensive participants who were covered by the National Health Insurance Service (NHIS) from 2009 to 2012 in Korea were included in the study. The participants were divided into six groups according to the level of baseline WC with a 5-cm interval starting from 80 cm in men and 75 cm in women. The risk for the future development of hypertension was assessed in 2015 using the claims data on the diagnosis of hypertension and prescription of anti-hypertensive medications. Approximately 7.8% of the participants developed hypertension over a median follow-up of 5.48 years. The proportion of participants who developed hypertension significantly increased from 4.2% in the WC level 1% to 17.5% in the WC level 6. After adjusting for confounding factors, level 6 of the baseline WC had a higher hazard ratio (HR) for the development of hypertension among the 6 levels of baseline with level 3 as the reference (1736; 95% confidence interval [95% CI]: 1.72-1.753). The participants with abdominal obesity had a significantly higher HR than those without abdominal obesity regardless of whether they engage in high- or moderate-intensity physical intensity (1.741; 95% CI: 1.718-1.764). WC had a linear association with the development of hypertension based on this large nationwide population-based cohort study, which was not influenced by physical activity.
腹部肥胖和缺乏身体活动都是高血压发展的危险因素。本研究旨在根据基线腰围（WC）分析高血压发病风险。本研究共纳入了 2009 年至 2012 年期间参加韩国国民健康保险服务（NHIS）的 16312477 名非高血压参与者。根据基线 WC 水平，参与者被分为 6 组，每组间隔 5cm，男性从 80cm 开始，女性从 75cm 开始。使用高血压诊断和抗高血压药物处方的索赔数据，于 2015 年评估未来高血压发病风险。在中位随访 5.48 年后，约 7.8%的参与者发生了高血压。随着 WC 水平从 1%增加到 6%，发生高血压的参与者比例从 4.2%显著增加。在校正混杂因素后，与 WC 水平 3 相比，基线 WC 水平 6 发生高血压的危险比（HR）更高（1736；95%置信区间[95%CI]：1.72-1.753）。与无腹部肥胖者相比，无论是否进行高强度或中强度体力活动，腹部肥胖者发生高血压的 HR 均显著升高（1.741；95%CI：1.718-1.764）。基于这项大型全国人群队列研究，WC 与高血压的发生呈线性关联，不受体力活动的影响。
