Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Songhe Shi, 100 Kexue Avenue, Zhengzhou, Henan, 450001, People's Republic of China.
Department of Neurology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
BMC Geriatr. 2021 Apr 19;21(1):260. doi: 10.1186/s12877-021-02154-5.
The relationship between obesity and prevalent high blood pressure in older adults has predominantly been estimated using categorical measures of body mass index (BMI) and waist circumference (WC), masking the shape of the dose-response relationship. We aimed to examine the precise relationship of BMI, WC with high blood pressure and to assess the appropriate level of BMI and WC for high blood pressure.
We examined data for 126,123 individuals in Xinzheng city aged ≥60 years from a population based study from January to December 2019. Logistic regression and restricted cubic spline models were applied to assess the relationship and the appropriate level of BMI and WC for high blood pressure. An additive interaction analysis was used to test synergistic effects between a higher BMI and WC for high blood pressure.
The full-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of an increase of 1 kg/m in BMI and 1 cm in WC for high blood pressure were 1.084 (1.080-1.087) and 1.026(1.024-1.027), respectively. Multivariable adjusted restricted cubic spline analyses showed the nonlinear relationships of BMI and WC with high blood pressure in both men and women (all P < 0.001). The risk of high blood pressure increased steeply with increasing BMI from ≥25 kg/m and WC ≥ 88 cm or 86 cm for males and females, respectively. And we observed a significant additive interaction between a higher BMI and WC such that the prevalence of high blood pressure was significantly enhanced.
These findings suggest increased high blood pressure prevalence in the older adults with increased BMI and WC. BMI ≤ 25 kg/m2 and WC ≤ 88 cm or 86 cm for males and females may be the best suggestion with regard to primary prevention of high blood pressure in older adults.
肥胖与老年人高血压之间的关系主要是通过身体质量指数（BMI）和腰围（WC）的分类测量来估计的，掩盖了剂量反应关系的形状。我们旨在研究 BMI 和 WC 与高血压的确切关系，并评估 BMI 和 WC 与高血压的适当水平。
我们对 2019 年 1 月至 12 月期间一项基于人群的研究中来自新郑市的 126123 名≥60 岁的个体进行了数据分析。应用逻辑回归和限制立方样条模型评估 BMI 和 WC 与高血压的关系和适当水平。采用加性交互作用分析检验 BMI 和 WC 升高对高血压的协同作用。
全调整后的 BMI 每增加 1kg/m2 和 WC 每增加 1cm 高血压的比值比（OR）及其 95%置信区间（CI）分别为 1.084（1.080-1.087）和 1.026（1.024-1.027）。多变量调整后的限制立方样条分析显示，BMI 和 WC 与高血压之间存在非线性关系，无论男女（均 P<0.001）。高血压的风险随着 BMI 从≥25kg/m2 和 WC≥88cm 或男性和女性分别为 86cm 而急剧增加。我们观察到 BMI 和 WC 之间存在显著的加性交互作用，即高血压的患病率显著增加。
这些发现表明，BMI 和 WC 增加的老年人高血压患病率增加。对于老年人高血压的一级预防，BMI≤25kg/m2 和 WC≤88cm 或 86cm 可能是最佳建议。
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