Kaufman J S, Durazo-Arvizu R A, Rotimi C N, McGee D L, Cooper R S
Department of Preventive Medicine and Epidemiology, Loyola University Stritch School of Medicine, Maywood, IL 60153, USA.
Epidemiology. 1996 Jul;7(4):398-405. doi: 10.1097/00001648-199607000-00010.
Obesity has been shown to be associated with hypertension in Africa, the Caribbean, and the United States, but there has not previously been an opportunity to compare the magnitude of this relation and estimate the contribution of obesity to hypertension risk across these populations. The International Collaborative Study on Hypertension in Blacks (ICSHIB) used age-stratified sampling and a standardized protocol to measure blood pressure and hypertension risk factors. We analyzed data on 9,102 men and women, age 25-74 years, from seven sites. We studied hypertension (140/90 mmHg or medication) in relation to body mass index (BMI) and sex-specific BMI cut-points designating "overweight" and "obesity." The prevalence of these conditions ranged from 6% to 63% for overweight, from 1% to 36% for obesity, and from 12% to 35% for hypertension. Adjusted relative risks were similar in most sites, ranging from 1.3 to 2.3 for both cut-points. We found that 6-29% of hypertension in each population was attributable to overweight and 0-16% to obesity. Comparing rural Africa with the United States, 43% of the difference in hypertension prevalence for women was attributable to overweight, and 22% for men, whereas respective values for obesity were 14% and 11%. These results indicate that the association between adiposity and hypertension is roughly constant across a range of environments, with little evidence for variation in susceptibility to effects of overweight in these groups.
在非洲、加勒比地区和美国，肥胖已被证明与高血压有关，但此前一直没有机会比较这种关系的程度，并估计肥胖对这些人群高血压风险的影响。黑人高血压国际协作研究（ICSHIB）采用年龄分层抽样和标准化方案来测量血压和高血压风险因素。我们分析了来自七个地点的9102名年龄在25 - 74岁之间的男性和女性的数据。我们研究了高血压（血压140/90 mmHg或正在接受药物治疗）与体重指数（BMI）以及指定“超重”和“肥胖”的性别特异性BMI切点之间的关系。这些情况的患病率超重范围为6%至63%，肥胖范围为1%至36%，高血压范围为12%至35%。在大多数地点，调整后的相对风险相似，两个切点的相对风险范围均为1.3至2.3。我们发现，在每个人群中，6% - 29%的高血压可归因于超重，0% - 16%可归因于肥胖。将非洲农村地区与美国进行比较，女性高血压患病率差异的43%可归因于超重，男性为22%，而肥胖的相应比例分别为14%和11%。这些结果表明，在一系列环境中，肥胖与高血压之间的关联大致恒定，几乎没有证据表明这些群体对超重影响的易感性存在差异。
