Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, P. R. China.
Department of Cardiology, Shengjing Hospital of China Medical University, P. R. China.
Nutrition. 2020 Jun;74:110755. doi: 10.1016/j.nut.2020.110755. Epub 2020 Jan 30.
The aim of this study was to evaluate hypertension risk associated with long- and short-term body mass index (BMI) changes.
This prospective cohort study included four examinations: 2004 to 2006, 2008, 2010, and 2017. Adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of BMI changes on incident hypertension. The difference of β coefficients between long- and short-term BMI changes were examined using Fisher Z-test.
Relative to stable, normal BMI, both long- and short-term elevated BMI conferred an increased risk for hypertension, with HRs of 1.507 (95% CI, 1.286-1.767) and 1.197(95% CI, 1.019-1.405), respectively. In contrast, relative to stable overweight, both long- and short-term decreased BMI conferred a reduced risk for hypertension, with HRs of 0.651(95% CI, 0.536-0.789) and 0.775 (0.625-0.962), respectively. Additionally, for BMI changing from normal to overweight, long-term changes were relatively more strongly associated with increased risk for incident hypertension than short-term based on regression coefficients (β = 0.410 versus β = 0.179, P < 0.001). For BMI changing from overweight to normal, long-term changes were relatively more strongly associated with lower risk than short-term based on regression coefficients (β = -0.430 versus β = -0.254, P = 0.007). Additionally, there was no correlation between absolute changes in BMI and systolic blood pressure for long- (P = 0.744) and short-term (P = 0.097).
For participants with normal BMI, risk tended to be higher in adults whose elevated BMI occurred during the long-term. For those who are overweight, long-term decreased BMI can reduce the risk for incident hypertension to a greater extent. No correlation was found between absolute changes in BMI and systolic blood pressure.
本研究旨在评估长期和短期体重指数（BMI）变化与高血压风险的关系。
这是一项前瞻性队列研究，共纳入了四次体检：2004 年至 2006 年、2008 年、2010 年和 2017 年。采用调整后的 Cox 比例风险模型估计 BMI 变化与新发高血压的风险比（HR）和 95%置信区间（CI）。采用 Fisher Z 检验比较长期和短期 BMI 变化的β系数差异。
与稳定的正常 BMI 相比，长期和短期 BMI 升高均与高血压风险增加相关，HR 分别为 1.507（95%CI，1.286-1.767）和 1.197（95%CI，1.019-1.405）。相比之下，与稳定的超重相比，长期和短期 BMI 降低均与高血压风险降低相关，HR 分别为 0.651（95%CI，0.536-0.789）和 0.775（95%CI，0.625-0.962）。此外，对于 BMI 从正常到超重的变化，基于回归系数，长期变化与新发高血压风险的相关性较短期变化更强（β=0.410 对 β=0.179，P<0.001）。对于 BMI 从超重到正常的变化，基于回归系数，长期变化与较低的风险相关性较短期变化更强（β=-0.430 对 β=-0.254，P=0.007）。此外，长期（P=0.744）和短期（P=0.097）BMI 绝对变化与收缩压之间均无相关性。
对于 BMI 正常的参与者，BMI 升高发生在长期时，风险往往更高。对于超重者，长期 BMI 降低可更大程度地降低新发高血压的风险。BMI 绝对变化与收缩压之间无相关性。
