Li An-le, Peng Qian, Shao Yue-Qin, Fang Xiang, Zhang Yi-Ying
Jiading district center for disease control and prevention, Shanghai, China.
Clin Hypertens. 2019 Feb 21;25:6. doi: 10.1186/s40885-019-0111-2. eCollection 2019.
BMI is an indicator commonly used in the world to measure the weight and height of the body, it reflects the comprehensive outcome of acquired lifestyle; FH is a sign reflecting the main role of genetic factors. This study aimed to evaluate the effect of BMI and interaction with FH on hypertension risk in Shanghai adult population.
According to l:l matched pairs design, 342 cases and 342 controls were selected and investigated in this study, this study was performed in Shanghai, China. Participants received face-to-face questionnaire survey, anthropometric tests and laboratory examinations. Relevant indicators that reflect obesity including BMI and waist to hip ratio (WHR) were calculated. Multivariate logistic regression analysis was applied to explore the association between factors and hypertension risk. Interactive effect was evaluated by synergy index (SI), relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and the percentage of the interaction between the pure factors (PAP).
Among 684 study participants aged 28-87 years old, the differences of mean age and height between case group and control group are no significant ( > 0.05), but the differences of mean of weight, WC, HC, BMI and WHR are significant ( < 0.001). The OR of FH on hypertension is 4.986 (95%CI: 2.832~ 8.877); the OR of BMI on hypertension is respectively: low weight is 1.528 (95%CI: 0.551~ 4.239), overweight is 3.333 (95%CI: 1.678~ 6.617) and obesity is 7.312 (95%CI: 3.556~ 15.035). The OR of interaction between FH and BMI to hypertension is 12.993 (95%CI: 7.42622.734). SI is 1.90 (95% CI: 1.483.78), RERI is 5.67 (95% CI: 1.6611.88), AP is 43.87% (95% CI: 12.8491.88%), and PAP is 47.55% (95%CI: 13.91~99.58%). FH and BMI have positive interaction on hypertension. 43.87% of hypertension exposed to both FH and BMI was attributable to the interaction of them.
FH and BMI are significant higher risks of hypertension; with the increase of BMI, the risk of hypertension will increase more. FH and BMI have positive interaction with hypertension, the interaction is greater than the sum of two independent actions.
BMI是全球常用的衡量身体体重和身高的指标，反映了后天生活方式的综合结果；家族史（FH）是反映遗传因素主要作用的一个标志。本研究旨在评估BMI及其与家族史的相互作用对上海成年人群高血压风险的影响。
本研究按照1:1匹配对设计，选取了342例病例和342例对照进行调查，研究在中国上海进行。参与者接受面对面问卷调查、人体测量测试和实验室检查。计算了反映肥胖的相关指标，包括BMI和腰臀比（WHR）。应用多因素logistic回归分析来探讨各因素与高血压风险之间的关联。通过协同指数（SI）、交互作用所致相对超额危险度（RERI）、交互作用所致归因比例（AP）以及纯因素间交互作用百分比（PAP）来评估交互效应。
在684名年龄在28 - 87岁的研究参与者中，病例组和对照组之间的平均年龄和身高差异无统计学意义（P>0.05），但体重、腰围、臀围、BMI和WHR的均值差异有统计学意义（P<0.001）。家族史对高血压的OR值为4.986（95%CI：2.8328.877）；BMI对高血压的OR值分别为：低体重者为1.528（95%CI：0.5514.239），超重者为3.333（95%CI：1.6786.617），肥胖者为7.312（95%CI：3.55615.035）。家族史与BMI对高血压的交互作用OR值为12.993（95%CI：7.42622.734）。SI为1.90（95%CI：1.483.78），RERI为5.67（95%CI：1.6611.88），AP为43.87%（95%CI：12.8491.88%），PAP为47.55%（95%CI：13.91~99.58%）。家族史和BMI在高血压方面存在正向交互作用。同时暴露于家族史和BMI的高血压患者中，43.87%可归因于它们之间的交互作用。
家族史和BMI是高血压的显著高危因素；随着BMI的增加，高血压风险增加得更多。家族史和BMI在高血压方面存在正向交互作用，该交互作用大于两个独立作用之和。
