Boss mass index and mortality from cardiovascular disease in China: a prospective study in rural men

Abstract

Objective: To assess the relationship between body mass index (BMI) and death risk of cardiovascular disease (CVD) in rural male population. Methods: 22 282 men aged 40 years older in Tanghe county and Fenghuang county from the cohort of the "Prospective Study on Adult Behavior and Health Risk Factors in China" were selected as subjects of this study. Cox regression model was used to calculate the hazard ratios (HRs) of the death of CVD during the follow-up period with different BMI groups at baseline. Results: The average follow-up period in the two counties was (19.1±8.7) years and 10 828 (48.6%) people died during the follow-up period. 4 504 deaths were attributed to CVD. Among the deaths of CVD, 1 279 cases died of ischemic heart disease (IHD), ischemic stroke (IS) died in 1 201, cases died of died of 1 317 hemorrhagic stroke (HS), other 707 cases. Compared to population with BMI<18 kg/m(2), Cox regression model (adjusting factors of region, age, nationality, education level, occupation, smoking, drinking, blood pressure, blood pressure, etc.) showed that people with BMI between 20-22 kg/m(2) had the lowest risk of CVD death (HR=0.95, 95%CI: 0.83-1.09). But the difference was not statistically significant among each BMI group (P>0.05). The risk of IHD death was the lowest in the population with BMI between 20-22 kg/m(2) (P<0.05) (HR=0.64, 95%CI: 0.52-0.80). There was no statistically significant difference between the risk of IHD death in the population with BMI≥24 kg/m(2) and that in the population with BMI<18 kg/m(2) (P>0.05). There was no statistically significant difference between the risk of IS death and BMI (P>0.05). The death risk of HS in the population with BMI between 18-24 kg/m(2) was higher than that in the population with BMI<18 kg/m(2) (P<0.05). The death risk of the population with BMI between 26-28 kg/m(2) was the highest (HR=1.88, 95%CI:1.18-2.99). Conclusions: The mortality risk of CVD and IHD was the lowest in lean or normal weight group, and HS was higher in overweight group. Maintaining a reasonable weight can reduce the risk of death in patients with CVD.