Bunker C H, Ukoli F A, Matthews K A, Kriska A M, Huston S L, Kuller L H
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA.
Hypertension. 1995 Oct;26(4):616-23. doi: 10.1161/01.hyp.26.4.616.
Hypertension is virtually absent in very lean rural African populations but is becoming more common in higher-weight urban African populations and is very common in predominantly obese Westernized black populations. This implies that there is a threshold above which weight is related to blood pressure. We studied urban Nigerian civil servants, a lean population in transition toward a more Westernized lifestyle. Blood pressure, fat-related measurements, fasting insulin, physical activity, alcohol intake, macronutrient intake, and electrolyte excretion were measured in 500 male and 299 female civil servants in Benin City, Nigeria, in 1992. Median body mass index (BMI) was 21.5 kg/m2 in men and 24.0 kg/m2 in women. Examination of age-adjusted mean blood pressure across quantiles of BMI in men and women suggested a threshold of 21.5 kg/m2 below which blood pressure was not correlated with BMI. Above this threshold blood pressure was correlated with BMI. Comparison of groups above and below the lower BMI threshold found that differences in blood pressure-BMI covariation were not explained by differences in alcohol intake, caloric or macronutrient intake, or electrolyte excretion. Physical activity was higher in men below the threshold. Fasting insulin and waist-hip ratio were strongly correlated with BMI even in this very lean population but neither was independently related to blood pressure. We conclude that there is a threshold below which little relationship between blood pressure and weight is observed. Above this threshold even at levels considered lean in US blacks, weight is a major determinant of blood pressure in this population of African blacks, which shares ancestry with US blacks.
在非常瘦的非洲农村人口中几乎不存在高血压，但在体重较高的非洲城市人口中越来越普遍，而在以肥胖为主的西方化黑人人口中则非常常见。这意味着存在一个阈值，超过该阈值体重就与血压相关。我们研究了尼日利亚城市公务员，这是一个正朝着更西方化生活方式转变的瘦人群体。1992年，对尼日利亚贝宁城的500名男性和299名女性公务员进行了血压、脂肪相关测量、空腹胰岛素、身体活动、酒精摄入量、常量营养素摄入量和电解质排泄量的测量。男性的中位体重指数（BMI）为21.5kg/m²，女性为24.0kg/m²。对男性和女性按BMI分位数进行年龄调整后的平均血压检查表明，阈值为21.5kg/m²，低于该阈值血压与BMI不相关。高于此阈值，血压与BMI相关。比较BMI下限阈值上下的组发现，血压 - BMI协变量的差异不能用酒精摄入量、热量或常量营养素摄入量或电解质排泄量的差异来解释。阈值以下的男性身体活动水平较高。即使在这个非常瘦的人群中，空腹胰岛素和腰臀比也与BMI密切相关，但两者均与血压无独立关联。我们得出结论，存在一个阈值，低于该阈值时血压与体重之间几乎没有关系。高于此阈值，即使在美国黑人认为是瘦的水平上，体重也是与美国黑人有共同祖先的非洲黑人人群中血压的主要决定因素。
