School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen, Guangdong, People's Republic of China.
J Hum Hypertens. 2021 Mar;35(3):215-225. doi: 10.1038/s41371-020-0322-8. Epub 2020 Mar 13.
Whether dynamic change in waist circumference is associated with progression from prehypertension to hypertension is not well understood. We explored this issue. A total of 4221 prehypertensive adults ≥18 years were enrolled during 2007-2008 and followed up during 2013-2014. Participants were classified by percentage waist-circumference change at follow-up: ≤-2.5, -2.5 to ≤2.5, 2.5 to ≤5.0, and >5.0%. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with logistic regression models, with stable waist-circumference change (-2.5 to 2.5%) as the reference. During the 6 years of follow-up, 1464 prehypertensive patients (851 women) showed progression to hypertension, with an incidence rate of 32.7% for men and 36.3% for women. As compared with stable waist circumference, a waist-circumference gain > 5.0% was associated with increased hypertension risk: adjusted ORs (95% CI) were 1.08 (1.01-1.14) for men and 1.09 (1.04-1.15) for women. The risk also decreased significantly for men with ≥2.5% waist-circumference loss (OR = 0.94, 95% CI 0.88-1.00). We found a linear association between percentage waist-circumference gain and risk of progression from prehypertension to hypertension for both sexes by restricted cubic splines (p = 0.772 for men and 0.779 for women). For each 10% gain in waist circumference, the risk increased by 8% for men and 5% for women. The association remained significant for both sexes in a subgroup analysis by abdominal obesity at baseline. The long-term gain in waist circumference significantly increased the risk of progression from prehypertension to hypertension for both sexes in a rural Chinese population, regardless of abdominal obesity status at baseline.
腰围的动态变化与高血压前期进展为高血压之间的关系尚不清楚。我们探讨了这个问题。2007-2008 年共纳入 4221 名年龄≥18 岁的高血压前期成年人，并于 2013-2014 年进行了随访。根据随访时腰围变化的百分比进行分类：≤-2.5、-2.5 至≤2.5、2.5 至≤5.0 和>5.0%。采用 logistic 回归模型计算比值比（OR）和 95%置信区间（CI），以稳定的腰围变化（-2.5 至 2.5%）为参照。在 6 年的随访期间，1464 名高血压前期患者（851 名女性）发展为高血压，男性的发病率为 32.7%，女性为 36.3%。与稳定的腰围相比，腰围增加>5.0%与高血压风险增加相关：男性的调整 OR（95%CI）为 1.08（1.01-1.14），女性为 1.09（1.04-1.15）。男性腰围减少≥2.5%的风险也显著降低（OR=0.94，95%CI 0.88-1.00）。我们通过限制性立方样条发现，男女两性腰围百分比增加与高血压前期进展为高血压之间存在线性关系（男性 p=0.772，女性 p=0.779）。男性腰围每增加 10%，风险增加 8%，女性增加 5%。在基线有腹型肥胖的亚组分析中，这种关联对男女两性仍然具有统计学意义。在中国农村人群中，无论基线时是否存在腹型肥胖，腰围的长期增加都会显著增加从高血压前期进展为高血压的风险。
