Abstract
The association between elevated body mass index (BMI) and risk of death has been reported in many studies. However, the association between BMI and all-cause mortality for hypertensive Chinese adults remains unclear. We conducted a post-hoc analysis using data from the China Stroke Primary Prevention Trial (CSPPT). Cox regression analysis was performed to determine the significance of the association of BMI with all-cause mortality. During a mean follow-up duration of 4.5 years, 622 deaths (3.0%) occurred among the 20,694 participants aged 45–75 years. A reversed J-shaped relationship was observed between BMI and all-cause mortality. The hazard ratios (HRs) for underweight (<18.5 kg/m2), overweight (24.0–27.9 kg/m2), and obesity (≥28.0 kg/m2) were calculated relative to normal weight (18.5–23.9 kg/m2). The summary HRs were 1.56 (95% CI, 1.11–2.18) for underweight, 0.78 (95% CI 0.64–0.95) for overweight and 0.64 (95% CI, 0.48–0.85) for obesity. In sex-age-specific analyses, participants over 60 years of age had optimal BMI in the obesity classification and the results were consistent in both males and females. Relative to normal weight, underweight was associated with significantly higher mortality. Excessive weight was not associated with increased risk of mortality. Chinese hypertensive adults had the lowest mortality in grade 1 obesity.
Highlights
Obesity is a global epidemic issue that is highly prevalent in both developed and developing countries; it affects people of both sexes and all ages, has adverse health consequences, accrues large economic costs, and has negative social implications [1]
This post-hoc analysis utilizes data from the China Stroke Primary Prevention Trial (CSPPT), which enrolled 20,702 subjects with primary hypertension in a multi-community, randomized, double-blind, controlled trial to assess whether enalapril maleate and folic acid supplementation was more effective in reducing risk of stroke than enalapril maleate supplementation alone
Higher body mass index (BMI) categories were associated with younger age, female gender, better education, and higher levels of fasting blood glucose (FBG), total cholesterol (TC), TG, albumin, and baseline and on-treatment blood pressure measurements
Summary
Obesity is a global epidemic issue that is highly prevalent in both developed and developing countries; it affects people of both sexes and all ages, has adverse health consequences, accrues large economic costs, and has negative social implications [1]. Nutrients 2016, 8, 384 for overweight and obesity and to guide weight loss recommendations. In China, an increasingly large proportion of the population has a BMI ě 25 kg/m2 , the standard definition of overweight [2].
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