Jiahui Xu1, Rongrong Guo1, Yanxia Xie1, Jia Zheng1, Yali Wang1, Yue Dai1, Zhaoqing Sun2, Liying Xing3, Xingang Zhang4, Yingxian Sun5, Liqiang Zheng6. 1. Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, P. R. China. 2. Department of Cardiology, Shengjing Hospital of China Medical University, P. R. China. 3. Institute of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, P. R. China. 4. Department of Cardiology, the First Affiliated Hospital of China Medical University, P. R. China. 5. Department of Cardiology, Shengjing Hospital of China Medical University, P. R. China. Electronic address: sunyingxian12@126.com. 6. Department of Cardiology, Department of Library and Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, P. R. China. Electronic address: liqiangzheng@126.com.
Abstract
OBJECTIVES: The aim of this study was to evaluate hypertension risk associated with long- and short-term body mass index (BMI) changes. METHODS: This prospective cohort study included four examinations: 2004 to 2006, 2008, 2010, and 2017. Adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of BMI changes on incident hypertension. The difference of β coefficients between long- and short-term BMI changes were examined using Fisher Z-test. RESULTS: Relative to stable, normal BMI, both long- and short-term elevated BMI conferred an increased risk for hypertension, with HRs of 1.507 (95% CI, 1.286-1.767) and 1.197(95% CI, 1.019-1.405), respectively. In contrast, relative to stable overweight, both long- and short-term decreased BMI conferred a reduced risk for hypertension, with HRs of 0.651(95% CI, 0.536-0.789) and 0.775 (0.625-0.962), respectively. Additionally, for BMI changing from normal to overweight, long-term changes were relatively more strongly associated with increased risk for incident hypertension than short-term based on regression coefficients (β = 0.410 versus β = 0.179, P < 0.001). For BMI changing from overweight to normal, long-term changes were relatively more strongly associated with lower risk than short-term based on regression coefficients (β = -0.430 versus β = -0.254, P = 0.007). Additionally, there was no correlation between absolute changes in BMI and systolic blood pressure for long- (P = 0.744) and short-term (P = 0.097). CONCLUSION: For participants with normal BMI, risk tended to be higher in adults whose elevated BMI occurred during the long-term. For those who are overweight, long-term decreased BMI can reduce the risk for incident hypertension to a greater extent. No correlation was found between absolute changes in BMI and systolic blood pressure.
OBJECTIVES: The aim of this study was to evaluate hypertension risk associated with long- and short-term body mass index (BMI) changes. METHODS: This prospective cohort study included four examinations: 2004 to 2006, 2008, 2010, and 2017. Adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of BMI changes on incident hypertension. The difference of β coefficients between long- and short-term BMI changes were examined using Fisher Z-test. RESULTS: Relative to stable, normal BMI, both long- and short-term elevated BMI conferred an increased risk for hypertension, with HRs of 1.507 (95% CI, 1.286-1.767) and 1.197(95% CI, 1.019-1.405), respectively. In contrast, relative to stable overweight, both long- and short-term decreased BMI conferred a reduced risk for hypertension, with HRs of 0.651(95% CI, 0.536-0.789) and 0.775 (0.625-0.962), respectively. Additionally, for BMI changing from normal to overweight, long-term changes were relatively more strongly associated with increased risk for incident hypertension than short-term based on regression coefficients (β = 0.410 versus β = 0.179, P < 0.001). For BMI changing from overweight to normal, long-term changes were relatively more strongly associated with lower risk than short-term based on regression coefficients (β = -0.430 versus β = -0.254, P = 0.007). Additionally, there was no correlation between absolute changes in BMI and systolic blood pressure for long- (P = 0.744) and short-term (P = 0.097). CONCLUSION: For participants with normal BMI, risk tended to be higher in adults whose elevated BMI occurred during the long-term. For those who are overweight, long-term decreased BMI can reduce the risk for incident hypertension to a greater extent. No correlation was found between absolute changes in BMI and systolic blood pressure.
Authors: Camila Maciel de Oliveira; Francielle França da Rosa; Rafael de Oliveira Alvim; Carlos Alberto Mourão Junior; Mercedes Bacells; Chunyu Liu; Jessica Pavani; Robson Capasso; Fernando Augusto Lavezzo Dias; José Eduardo Krieger; Alexandre Costa Pereira Journal: J Clin Hypertens (Greenwich) Date: 2022-05-11 Impact factor: 2.885