Abstract
Objectives To assess the extent of interaction between body mass index (BMI) and triglyceride (TG) level and its effects on blood pressure (BP) in elderly individuals in China. Design Cross-sectional study. Setting Data were taken from a cross-sectional study called the China Health and Retirement Longitudinal Study. Participants The analytic sample included 3629 subjects aged 45 to 96 years. Main Outcome Measurements Data were obtained from the China Health and Retirement Longitudinal Study, which is a cross-sectional study. Age-adjusted partial Pearson's correlation test was used to compare various characteristics and BP. Adjusted associations were first used as linear regression models, as appropriate. Then, general linear models adjusted for related potential confounders were used to examine the synergistic effects of BMI and TG level on BP. Finally, a binary logistic regression model adjusted for confounding factors was used to examine the association between BMI or TG level and hypertension. Results Age-adjusted partial Pearson's correlation coefficient showed that the TG level was positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both men and women with BMI < 24.0 kg/m2; however, TG level was positively correlated with DBP in women with BMI ≥ 24.0 kg/m2 but not with DBP in men with BMI ≥ 24.0 kg/m2. Multiple linear regression analysis showed that BMI level was significantly and positively associated with both SBP and DBP in men and women with BMI < 24.0 kg/m2, and TG level was significantly and positively associated with SBP in women with BMI < 24.0 kg/m2, independent of other confounding factors. A general linear model analysis with adjustment for confounding factors (age, educational level, marital status, current residence, smoking, eating habits, taking activities, antidiabetic medication, antihypertensive therapy, fasting plasma glucose [FPG], low-density lipoprotein cholesterol [LDL-C], estimated glomerular filtration rate [eGFR], and serum uric acid [SUA]) showed no interaction between BMI and TG level and SBP (men, β = 0.572, P = 0.845; women, β = 0.122, P = 0.923) and DBP (men, β = -0.373, P = 0.810; women, β = 0.272, P = 0.828). A binary logistic regression model analysis with adjustment for confounding factors (age, educational level, marital status, current residence, smoking, drinking, eating habits, taking activities, major accidental injury, physical activity, history of cardiovascular disease, history of liver disease, antilipidemic medication, antidiabetic medication, antihypertensive therapy, FPG, LDL-C, high-density lipoprotein cholesterol [HDL-C], eGFR, and SUA) showed that overweight and obese men and women were more likely to have hypertension (men: odds ratio [OR] = 1.781, 95% confidence interval [CI] = 1.393–2.277; women: OR = 1.653, 95% CI = 1.330–2.055) and women with high TG were more likely to have hypertension (OR = 1.558, 95% CI = 1.219–1.992). Conclusion An interactive effect of BMI and TG level on BP was not observed in either men or women; however, independent effects of BMI on BP were observed in both men and women, and an association between TG level and hypertension was observed in women.
Highlights
The prevalence of hypertension has dramatically increased in the past few years in China[1, 2]; the rate of hypertension is disproportionately high among elderly individuals in this country[3,4,5]
Hypertension is defined as a diastolic blood pressure (DBP) of ≥ 90 mmHg and/or systolic blood pressure (SBP) of ≥ 140 mmHg based on the evidence of modestly increasing risk[6,7,8] and incidence of cardiovascular disease (CVD)[9,10,11]
Data for this cross-sectional study were taken from the China Health and Retirement Longitudinal Study (CHARLS), a biennial and nationally representative longitudinal survey conducted by the China Centre for Economic Research at Peking University [28]
Summary
The prevalence of hypertension has dramatically increased in the past few years in China[1, 2]; the rate of hypertension is disproportionately high among elderly individuals in this country[3,4,5]. Numerous studies[13,14,15,16,17,18,19,20] have been conducted to determine the risk factors for hypertension, such as aging, overweight, central obesity, lifestyle, family history of hypertension, history of diabetes and dyslipidemia, lack of physical activity, smoking, alcohol consumption, low-density lipoprotein cholesterol (LDL-C) level, triglycerides (TG) level, and high-density lipoprotein cholesterol (HDL-C) level. Brennan [23] conducted a study to investigate the effects of body weight on TG and SBP in individuals aged 20 to 49 years and found that, in men, significant correlations with BMI were found for all variables, while in women younger than 40, only the correlation with BP was significant. The association between TG level and risk of hypertension and the effects of obesity on this association are of considerable interest, and an interactive effect between body mass index (BMI) and TG level on BP may be considered
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