Bernabe-Ortiz Antonio, Carrillo-Larco Rodrigo M, Miranda J Jaime
CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
Universidad Cientifica del Sur, Lima, Peru.
PeerJ. 2021 Apr 21;9:e11307. doi: 10.7717/peerj.11307. eCollection 2021.
Understanding the relationship between BMI and blood pressure requires assessing whether this association is similar or differs across population groups. This study aimed to assess the association between body mass index (BMI) and blood pressure levels, and how these associations vary between socioeconomic groups and geographical settings.
Data from the National Demographic Health Survey of Peru from 2014 to 2019 was analyzed considering the complex survey design. The outcomes were levels of systolic (SBP) and diastolic blood pressure (DBP), and the exposure was BMI. Exposure and outcomes were fitted as continuous variables in a non-linear quadratic regression model. We explored effect modification by six socioeconomic and geographical variables (sex, age, education level, socioeconomic position, study area, and altitude), fitting an interaction term between each of these variables and BMI.
Data from 159, 940 subjects, mean age 44.4 (SD: 17.1), 54.6% females, was analyzed. A third (34.0%) of individuals had ≥12 years of education, 24.7% were from rural areas, and 23.7% lived in areas located over 2,500 m above sea level. In the overall sample mean BMI was 27.1 (SD: 4.6) kg/m, and mean SBP and DBP were 122.5 (SD: 17.2) and 72.3 (SD: 9.8) mmHg, respectively. In the multivariable models, greater BMI levels were associated with higher SBP (-value < 0.001) and DBP (-value < 0.001). There was strong evidence that sex, age, education level, and altitude were effect modifiers of the association between BMI and both SBP and DBP. In addition to these socio-demographic variables, socioeconomic position and study area were also effect modifiers of the association between BMI and DBP, but not SBP.
The association between BMI and levels of blood pressure is not uniform on a range of socio-demographic and geographical population groups. This characterization can inform the understanding of the epidemiology and rise of blood pressure in a diversity of low-resource settings.
了解体重指数（BMI）与血压之间的关系需要评估这种关联在不同人群组中是否相似或存在差异。本研究旨在评估体重指数（BMI）与血压水平之间的关联，以及这些关联在社会经济群体和地理环境之间如何变化。
考虑到复杂的调查设计，对2014年至2019年秘鲁全国人口健康调查的数据进行了分析。结果变量为收缩压（SBP）和舒张压（DBP）水平，暴露变量为BMI。在非线性二次回归模型中，将暴露变量和结果变量作为连续变量进行拟合。我们通过六个社会经济和地理变量（性别、年龄、教育水平、社会经济地位、研究区域和海拔）探讨效应修正，在每个变量与BMI之间拟合一个交互项。
分析了159,940名受试者的数据，平均年龄44.4岁（标准差：17.1），女性占54.6%。三分之一（34.0%）的个体接受过≥12年教育，24.7%来自农村地区，23.7%生活在海拔2500米以上的地区。在总体样本中，平均BMI为27.1（标准差：4.6）kg/m²，平均SBP和DBP分别为122.5（标准差：17.2）和72.3（标准差：9.8）mmHg。在多变量模型中，较高的BMI水平与较高的SBP（p值<0.001）和DBP（p值<0.001）相关。有充分证据表明，性别、年龄、教育水平和海拔是BMI与SBP和DBP之间关联的效应修正因素。除了这些社会人口学变量外，社会经济地位和研究区域也是BMI与DBP之间关联的效应修正因素，但不是BMI与SBP之间关联的效应修正因素。
在一系列社会人口学和地理人群组中，BMI与血压水平之间的关联并不一致。这一特征有助于理解各种资源匮乏环境中高血压的流行病学情况及其上升趋势。
