Tibet Center for Disease Control and Prevention, 21 North linkuo Road, Lhasa, Tibet, China.
Wuzhong District Center for Disease Control and Prevention, Suzhou City, China.
BMC Public Health. 2023 Sep 21;23(1):1840. doi: 10.1186/s12889-023-15864-9.
Previous studies have identified that socioeconomic status (SES) and obesity are associated with hypertension. However, their interaction on hypertension risk has not yet been assessed.
The study used data from 6,069 Tibetan residents in Chengguan District in Lhasa, the Chinese Tibetan autonomous region's capital, based on a cohort study conducted from May 2018 to September 2019 in five provinces in southwest China. We used logistic regression models to assess the complex relations of SES and obesity with hypertension.
Compared with individuals of high SES, low and moderate SES were positively associated with high risk of hypertension. SES and obesity have significant additive interaction on hypertension (general obesity by BMI: RERI = 1.33, P < 0.001; abdominal obesity by WC: RERI = 0.76, P < 0.001; abdominal obesity by WHtR: RERI = 0.96, P < 0.001). In people from the low and moderate SES segments, obesity was linked to an increased risk of hypertension, but the correlations were stronger in people from the moderate SES category. Compared with people of high SES and non obese, those with moderate SES and obesity had a higher risk of hypertension, and ORs were 4.38 (2.80, 6.84) for general obesity by BMI, 3.38 (2.05, 5.57) for abdominal obesity by WC, and 3.18 (1.57, 6.42) for abdominal obesity by WHtR.
There is an independent and additive interaction effect of obesity and SES on the risk of hypertension. People with obesity, especially those of moderate and low SES, should reduce weight and waist circumference, and pay more attention to blood pressure. Moreover, the government, health administration departments, and society should prioritize improving the socioeconomic status of the Tibetan population and addressing risk factors like obesity.
既往研究已证实社会经济地位（SES）和肥胖与高血压相关。然而，它们对高血压风险的交互作用尚未得到评估。
本研究基于 2018 年 5 月至 2019 年 9 月在中国西南五省开展的一项队列研究，使用中国西藏自治区首府拉萨城关区 6069 名藏族居民的数据。我们采用 logistic 回归模型评估 SES 和肥胖与高血压的复杂关系。
与 SES 较高者相比，SES 较低和中等者与高血压高危呈正相关。SES 和肥胖对高血压有显著的相加交互作用（BMI 相关的一般肥胖：RERI=1.33，P<0.001；WC 相关的腹型肥胖：RERI=0.76，P<0.001；WHtR 相关的腹型肥胖：RERI=0.96，P<0.001）。在 SES 较低和中等组人群中，肥胖与高血压风险增加相关，且在 SES 中等组人群中相关性更强。与 SES 较高且不肥胖者相比，SES 中等且肥胖者高血压风险更高，OR 值分别为 BMI 相关的一般肥胖者 4.38（2.80，6.84）、WC 相关的腹型肥胖者 3.38（2.05，5.57）和 WHtR 相关的腹型肥胖者 3.18（1.57，6.42）。
肥胖和 SES 对高血压风险有独立且相加的交互作用。肥胖人群，尤其是 SES 较低和中等者，应减轻体重和腰围，更加关注血压。此外，政府、卫生行政部门和社会应优先提高藏族人群的社会经济地位，并解决肥胖等危险因素。
