Abstract

BackgroundStudies on the association between body mass index (BMI) and death risk among patients with hypertension are limited, and the results are inconsistent. We investigated the association between BMI and cardiovascular disease (CVD) and all-cause mortality among hypertensive patients in a population of Beijing, China.MethodsWe conducted a prospective cohort study of 2535 patients with hypertension aged 40 to 91 years from Beijing, China. Participants with a history of CVD at baseline were excluded from analysis. Cox proportional hazards regression models were used to estimate the association of different levels of BMI stratification with CVD and all-cause mortality.ResultsDuring a mean follow-up of 8.1 years, 486 deaths were identified, including 233 cases of CVD death. The multivariable-adjusted hazards ratios for all-cause mortality associated with BMI levels (<20, 20–22, 22–24, 24–26 [reference group], 26–28, 28–30, and ≥30 kg/m2) were 2.03 (95% confidence interval [CI], 1.48–2.78), 1.61 (95% CI, 1.18–2.20), 1.30 (95% CI, 0.95–1.78), 1.00 (reference), 1.12 (95% CI, 0.77–1.64), 1.33 (95% CI, 0.90–1.95), and 1.66 (95% CI, 1.10–2.49), respectively. When stratified by age, sex, or smoking status, the U-shaped association was still present in each subgroup (P > 0.05 for all interactions). Regarding the association of BMI with CVD mortality, a U-shaped trend was also observed.ConclusionsThe present study showed a U-shaped association of BMI with CVD and all-cause mortality among patients with hypertension. A lowest risk of all-cause mortality was found among hypertensive patients with BMI between 24 and 26 kg/m2.

Highlights

  • Hypertension is considered to be the leading risk factor for cardiovascular mortality and accounts for a large proportion of premature deaths in China as well as in Western countries.[1,2] Obesity is recognized as a major global epidemic health problem and is associated with an increasing prevalence of hypertension.[3,4,5] the relationship between body mass index (BMI) and mortality among patients with hypertension is unclear, and reports regarding their association are limited

  • The aim of the present study was to investigate the association of different levels of BMI at baseline with risk of all-cause and cardiovascular disease (CVD) mortality among patients with hypertension in a prospective cohort study conducted in Beijing, China

  • We observed a trend toward increased risk of CVD mortality among hypertensive subjects with BMI

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Summary

Introduction

Hypertension is considered to be the leading risk factor for cardiovascular mortality and accounts for a large proportion of premature deaths in China as well as in Western countries.[1,2] Obesity is recognized as a major global epidemic health problem and is associated with an increasing prevalence of hypertension.[3,4,5] the relationship between body mass index (BMI) and mortality among patients with hypertension is unclear, and reports regarding their association are limited. The aim of the present study was to investigate the association of different levels of BMI at baseline with risk of all-cause and CVD mortality among patients with hypertension in a prospective cohort study conducted in Beijing, China. Studies on the association between body mass index (BMI) and death risk among patients with hypertension are limited, and the results are inconsistent. A lowest risk of all-cause mortality was found among hypertensive patients with BMI between 24 and 26 kg/m2

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