Jousilahti P, Tuomilehto J, Vartiainen E, Valle T, Nissinen A
National Public Health Institute, Department of Epidemiology and Health Promotion, Mannerheimintie 160, Helsinki, Finland.
J Hum Hypertens. 1995 Oct;9(10):847-54.
We analysed the association of body mass index (BMI) with blood pressure (BP) at baseline, whether BMI predicts the incidence of anti-hypertensive drug treatment during a 12-year follow-up and whether this risk is independent of the original BP level and, finally, how diabetes associates with the incidence of anti-hypertensive drug treatment. The study population comprised 15,438 men and women in eastern Finland aged between 30 and 59 years who were not using anti-hypertensive drug treatment during baseline surveys in 1972 and 1977. At baseline BP increased linearly by increasing BMI. The proportion of hypertensive subjects, defined as either DBP > or = 95 mm Hg or SBP > or = 160 mm Hg, was 18% among the leanest men, BMI < 20 kg/m2, but 61% among the most obese, BMI > or = 30 kg/m2. Among women these proportions were 11% and 54%, respectively. Among the normotensive subjects at baseline, the BMI associated risk ratio of the incidence of anti-hypertensive drug treatment, adjusted for age and study year, was 1.14 (per kg/m2; P < 0.001) in men and 1.11 (P < 0.001) in women. After a further adjustment for DBP and SBP at baseline, risk ratios were 1.13 (P < 0.001) and 1.07 (P < 0.001), respectively. Diabetes associated with the risk of anti-hypertensive drug treatment independently from BMI, DBP and SBP. Because BMI correlates with BP cross-sectionally, and it also predicts the future increase in BP independently from the baseline BP, excess weight is undoubtedly one of the most important risk factors for hypertension. Weight control is the most natural primary intervention method in the inter-relation of obesity, hypertension and diabetes and in the prevention of subsequent cardiovascular diseases.
我们分析了基线时体重指数（BMI）与血压（BP）之间的关联，BMI是否能预测12年随访期间抗高血压药物治疗的发生率，以及这种风险是否独立于初始血压水平，最后，糖尿病与抗高血压药物治疗发生率之间的关联。研究人群包括芬兰东部15438名年龄在30至59岁之间的男性和女性，他们在1972年和1977年的基线调查中未使用抗高血压药物治疗。在基线时，血压随BMI的增加呈线性升高。高血压患者（定义为舒张压≥95mmHg或收缩压≥160mmHg）的比例在最瘦的男性（BMI<20kg/m²）中为18%，但在最肥胖的男性（BMI≥30kg/m²）中为61%。在女性中，这些比例分别为11%和54%。在基线时血压正常的受试者中，经年龄和研究年份调整后，男性抗高血压药物治疗发生率的BMI相关风险比为1.14（每kg/m²；P<0.001），女性为1.11（P<0.001）。在进一步调整基线时的舒张压和收缩压后，风险比分别为1.13（P<0.001）和1.07（P<0.001）。糖尿病与抗高血压药物治疗风险的关联独立于BMI、舒张压和收缩压。由于BMI与血压呈横断面相关，并且它还能独立于基线血压预测未来血压的升高，超重无疑是高血压最重要的危险因素之一。在肥胖、高血压和糖尿病的相互关系以及预防随后的心血管疾病方面，体重控制是最自然的主要干预方法。
