OBESITY AND MORTALITY - RESULTS FROM THE EPIDEMIOLOGY OF HYPERTENSION IN CROATIA (EHUH STUDY) - MORTALITY DATA AFTER 17 YEARS OF FOLLOW-UP

Abstract

Objective: Our aim was to analyze the association of obesity with all-cause and cardiovascular (CV) mortality in a random sample of Croatian population, an original cohort from the EH-UH study. Design and method: EH-UH study is a nation-wide survey on prevalence, treatment and control of hypertension in Croatia. In 2001–2003 a random sample of 1267 subjects were enrolled. Mortality data collected from the National Public Health Institute records were analyzed after an average period of 17 years. Subjects were divided in BMI1 (< 25 kg/m2), BMI2 (25–30 kg/m2) and BMI3 (>30 kg/m2). Results: There were significantly more all-cause deaths in BMI2 and BMI3 vs. BMI1(X 2 = 9.478; p = 0.002; X 2 = 9.959; p = 0.001; BMI 2 vs BMI3 p > 0.05). We failed to find differences in CV mortality among BMI groups. Subjects in BMI1 were younger than BMI2 and BMI3 (p < 0.01). There were more women than men in BMI1 and BMI3 (p = 0.007;p = 0.0015; respectively). BP values were significantly lower in BMI 1 vs. BMI2 and BMI3 (p < 0.01). BMI2 subjects had significantly lower BP values than BMI3. There were significantly more subjects with optimal BP in BMI1 group and high normal subjects in BMI3 group (p = 0.0000). Prevalence of hypertension was the highest in BMI3 and lowest in BMI1. There were no differences in achieved BP control. BMI1 was more educated (<8 vs >12years) than BMI 2 and BMI3 (p < 0.0001), and BMI2 than BMI3 (p < 0.005). Significantly more subjects with low income (< 400 Eu/months) were detected in BMI3 vs. BMI1 and BMI2 (X 2 = 10.426; p = 0.001; X 2 = 5.423; p = 0.019, respectively). Significant differences in smoking, alcohol intake, positive history of diabetes and dyslipidemia were observed among BMI groups. No difference in history for stroke or myocardial infarction were found. Conclusions: We failed to find increased CV mortality in obese and overweight subjects despite they were older, had more hypertension and were associated with various unfavourable risk factors and conditions. This could be explained with achieved same BP control and same past medical history. In addition, high cancer mortality observed in all BMI subgroups could attenuate association of BMI and CV deaths.