Abstract
Evidence was limited on trajectory of body mass index (BMI) through adulthood and its association with hypertension. We aimed to evaluate their association by sex in large-scale study. Data were obtained from the China Health and Nutrition Survey (CHNS) from 1991 to 2015. Latent class trajectory analysis (LCTA) was used to capture BMI change trajectories. Hazard risks (HRs) were estimated from Cox proportion hazard regression. Among 14,262 participants (mean age, 38.8; 47.8% men), 5138 hypertension occurred (2687 men and 2451 women) occurred during a mean follow-up 9.6 years. Four body mass trajectory groups were identified as BMI loss, stable, moderate and substantial gain. Appropriately half of participants (48.0%) followed 1 of the 2 BMI gain trajectories, where BMI increased at least 3 kg/m2 overtime. Compared with participants with stable BMI, those gaining BMI substantially had higher risk of hypertension by 65% (HR 1.65, 95% CI 1.45–1.86) in male and 83% (HR 1.83, 95% CI 1.58–2.12) in female. The HRs in BMI loss patterns were 0.74 (0.62–0.89) in men and 0.87 (0.75–1.00) in women. Our findings imply that majority of Chinese adults transited up to a higher BMI level during follow-up. Avoiding excessive weight gain and maintaining stable weight might be important for hypertension prevention.
Highlights
Evidence was limited on trajectory of body mass index (BMI) through adulthood and its association with hypertension
Data has been spare regarding the association of BMI change trajectory with hypertension in Chinese adults, who are suffering from increasingly severe epidemic of overweight/obesity[21]
We tried to address these limitations by utilizing the data from China Health and Nutrition Survey (CHNS), a national representative open cohort study
Summary
Evidence was limited on trajectory of body mass index (BMI) through adulthood and its association with hypertension. Evidence has been increasingly accumulated that BMI change is associated with additional health outcomes, compared to static weight status[13,14] These studies implied that the BMI change trajectories might be curvilinear and varied across race, and suggested that higher hypertension might attribute to steeper increase in the slope of B MI9,15–20. These efforts, useful, had several important limitations, including inaccurate calculation of BMI change by self-reported weight and height with a limited number of measurements, insufficient interpretation for gender difference, insufficient identification of within-person variation of physical activity or other lifestyle factors over time, and insufficient interpretation for the possible interaction with baseline weight status. We attempted to outline the specific BMI change trajectory related to higher risk of hypertension in order to assist policymakers in developing the targeted intervention strategies
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