Abstract
BackgroundThe relationship between obesity and prevalent high blood pressure in older adults has predominantly been estimated using categorical measures of body mass index (BMI) and waist circumference (WC), masking the shape of the dose-response relationship. We aimed to examine the precise relationship of BMI, WC with high blood pressure and to assess the appropriate level of BMI and WC for high blood pressure.MethodsWe examined data for 126,123 individuals in Xinzheng city aged ≥60 years from a population based study from January to December 2019. Logistic regression and restricted cubic spline models were applied to assess the relationship and the appropriate level of BMI and WC for high blood pressure. An additive interaction analysis was used to test synergistic effects between a higher BMI and WC for high blood pressure.ResultsThe full-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of an increase of 1 kg/m2 in BMI and 1 cm in WC for high blood pressure were 1.084 (1.080–1.087) and 1.026(1.024–1.027), respectively. Multivariable adjusted restricted cubic spline analyses showed the nonlinear relationships of BMI and WC with high blood pressure in both men and women (all P < 0.001). The risk of high blood pressure increased steeply with increasing BMI from ≥25 kg/m2 and WC ≥ 88 cm or 86 cm for males and females, respectively. And we observed a significant additive interaction between a higher BMI and WC such that the prevalence of high blood pressure was significantly enhanced.ConclusionThese findings suggest increased high blood pressure prevalence in the older adults with increased BMI and WC. BMI ≤ 25 kg/m2 and WC ≤ 88 cm or 86 cm for males and females may be the best suggestion with regard to primary prevention of high blood pressure in older adults.
Highlights
The relationship between obesity and prevalent high blood pressure in older adults has predominantly been estimated using categorical measures of body mass index (BMI) and waist circumference (WC), masking the shape of the dose-response relationship
We evaluated the additive interaction between BMI and WC for high blood pressure (HBP) with BMI and WC analyzed as continuous variable in two categories [(BMI: BMI < 25 and BMI ≥ 25
The basic demographic characteristics of the study population according to BMI and WC quintiles are shown in Tables 1 and 2
Summary
The relationship between obesity and prevalent high blood pressure in older adults has predominantly been estimated using categorical measures of body mass index (BMI) and waist circumference (WC), masking the shape of the dose-response relationship. We aimed to examine the precise relationship of BMI, WC with high blood pressure and to assess the appropriate level of BMI and WC for high blood pressure. Accumulating evidence suggests a potential link between obesity-related high blood pressure (HBP) [12,13,14], but controversy exists about the degree of the associations between two anthropometric indicators and the risk of HBP. Few studies have explored the dose–response relationship and investigated the interaction between BMI and WC. In this study, we aimed to assess the independent association of BMI and WC with HBP as well as their possible additive interactions on the risk of HBP using a large and contemporary population in central China and to explore the appropriate level of BMI and WC for the older adults
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