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BMI and risk of all-cause mortality in normotensive and hypertensive adults: the rural Chinese cohort study

Published online by Cambridge University Press:  16 April 2021

Qionggui Zhou
Affiliation:
Study Team of Shenzhen’s Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, 47 Youyi Road, Luohu District, Shenzhen, GD, People’s Republic of China
Xuejiao Liu
Affiliation:
Study Team of Shenzhen’s Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, 47 Youyi Road, Luohu District, Shenzhen, GD, People’s Republic of China
Yang Zhao
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Pei Qin
Affiliation:
Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, GD, People’s Republic of China
Yongcheng Ren
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Dechen Liu
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Leilei Liu
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Xu Chen
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Feiyan Liu
Affiliation:
Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, GD, People’s Republic of China
Cheng Cheng
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Chunmei Guo
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Quanman Li
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Gang Tian
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Xiaoyan Wu
Affiliation:
Study Team of Shenzhen’s Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, 47 Youyi Road, Luohu District, Shenzhen, GD, People’s Republic of China
Ranran Qie
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Minghui Han
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Shengbing Huang
Affiliation:
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhongyuan District, Zhengzhou, HN, People’s Republic of China
Lidan Xu
Affiliation:
Department of Nutrition, The Second Affiliated Hospital of Shenzhen University, 118 Longjing 2nd Road, Baoan District, Shenzhen, GD, People’s Republic of China
Ming Zhang
Affiliation:
Department of Epidemiology, School of Public Health, Shenzhen University Health Science Center, 3688 Nanhai Avenue, Nanshan District, Shenzhen, GD, People’s Republic of China
Dongsheng Hu
Affiliation:
Study Team of Shenzhen’s Sanming Project, The Affiliated Luohu Hospital of Shenzhen University Health Science Center, 47 Youyi Road, Luohu District, Shenzhen, GD, People’s Republic of China
Corresponding
E-mail address:

Abstract

Objective:

The impact of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to examine the moderation effect of hypertension on the BMI–mortality association using a rural Chinese cohort.

Design:

In this cohort study, we investigated the incident of mortality according to different BMI categories by hypertension status.

Setting:

Longitudinal population-based cohort.

Participants:

17 262 adults ≥18 years were recruited from July to August of 2013 and July to August of 2014 from a rural area in China.

Results:

During a median 6-year follow-up, we recorded 1109 deaths (610 with and 499 without hypertension). In adjusted models, as compared with BMI 22–24 kg/m2, with BMI ≤ 18, 18–20, 20–22, 24–26, 26–28, 28–30 and >30 kg/m2, the hazard ratios for mortality in normotensive participants were 1·92 (95% CI 1·23, 3·00), 1·44 (95% CI 1·01, 2·05), 1·14 (95% CI 0·82, 1·58), 0·96 (95% CI 0·70, 1·31), 0·96 (95% CI 0·65, 1·43), 1·32 (95% CI 0·81, 2·14) and 1·32 (95% CI 0·74, 2·35), respectively, and in hypertensive participants were 1·85 (95% CI 1·08, 3·17), 1·67 (95% CI 1·17, 2·39), 1·29 (95% CI 0·95, 1·75), 1·20 (95% CI 0·91, 1·58), 1·10 (95% CI 0·83, 1·46), 1·10 (95% CI 0·80, 1·52) and 0·61 (95% CI 0·40, 0·94), respectively. The risk of mortality was lower in individuals with hypertension with overweight or obesity v. normal weight, especially in older hypertensives (≥60 years old). Sensitivity analyses gave consistent results for both normotensive and hypertensive participants.

Conclusions:

Low BMI was significantly associated with increased risk of all-cause mortality regardless of hypertension status in rural Chinese adults, but high BMI decreased the mortality risk among individuals with hypertension, especially in older hypertensives.

Type
Research paper
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society

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Footnotes

These authors contributed equally to this work.

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