Association between obesity phenotypes and incident hypertension among Chinese adults: a prospective cohort study

Cao, Z.K.; Huang, Yao; Yu, Hong-jie; Yuan, Shuai; Tang, Bowen; Li, Q.X.; Li, X.T.; Yang, Xiaonan; He, Qingsong

doi:10.1016/j.puhe.2017.04.018

Cited by 11 publications

(16 citation statements)

References 25 publications

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“…Moreover, we found a large proportion of metabolically unhealthy people among non-obese people. This phenotype was also associated with increased risk of developing hypertension, which was consistent with previous findings (10,16) . This result indicates that screening for hypertension should also be implemented among non-obese people who may be potentially at high risk of hypertension but who are easily ignored.…”

Section: Discussionsupporting

confidence: 92%

“…The prevalence of MHO ranges from 1•1 to 28•5 % in different populations (30) . The prevalence of MHO we reported in our rural Chinese adults was obviously lower than that in previous studies because of the strictness of the metabolically healthy definition (16,31) . By contrast, the proportions of metabolically unhealthy individuals with or without obesity were relatively higher, which indicates the need for making interventional strategies to ensure that people are metabolically healthy in rural China.…”

Section: Discussioncontrasting

confidence: 89%

“…Metabolically healthy definitions including the Adult Treatment Panel III (28,29) , International Diabetes Federation (11,16) , Wildman (10) and Karelis (10) definitions are inconsistent and controversial and are generally applied to identify metabolically unhealthy status with more than two or three criteria. These definitions were criticised for considering people with one or two metabolically unhealthy criteria as metabolically healthy.…”

Section: Discussionmentioning

confidence: 99%

“…However, the study did not provide detailed results specifically for MHO people. The China Health and Nutrition Survey study considered overweight and general obesity as obesity and reported the prevalence of metabolically healthy as 70•1 % in adults (age range 18-65 years) with overweight/obesity (16) . It also found risk of hypertension increased with metabolically healthy overweight/obesity (1•78-fold increase, 95 % CI 1•39, 2 •27), which agrees with our findings.…”

Section: Discussionmentioning

confidence: 99%

“…Only two cohort studies have examined the MHO-hypertension association in Chinese adults. However, the Taiwan Survey focused only on general obesity, and the China Health and Nutrition Survey failed to consider several major confounding factors, including socioeconomic factors, family history of hypertension, diabetes status and lipid-lowering treatment (16,17) .…”

mentioning

confidence: 99%

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Metabolically healthy general and abdominal obesity are associated with increased risk of hypertension

Zhao

Qin

Sun³

et al. 2019

Br J Nutr

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Metabolically healthy obesity refers to a subset of obese people with a normal metabolic profile. We aimed to explore the association between metabolically healthy and obesity status and risk of hypertension among Chinese adults from The Rural Chinese Cohort Study. This prospective cohort study enrolled 9137 Chinese adults without hypertension, type 2 diabetes or treatment for lipid abnormality at baseline (2007–2008) and followed up during 2013–2014. Modified Poisson regression models were used to examine the risk of hypertension by different metabolically healthy and obesity status, estimating relative risks (RR) and 95 % CI. During 6 years of follow-up, we identified 1734 new hypertension cases (721 men). After adjusting for age, sex, smoking and other confounding factors, risk of hypertension was increased with metabolically healthy general obesity (MHGO) defined by BMI (RR 1·75, 95 % CI 1·02, 3·00) and metabolically healthy abdominal obesity (MHAO) defined by waist circumference (RR 1·51, 95 % CI 1·12, 2·04) as compared with metabolically healthy non-obesity. The associations between metabolically healthy and obesity status and hypertension outcome were consistent after stratifying by sex, age, smoking, alcohol drinking and physical activity. Both MHGO and MHAO were associated with increased risk of hypertension. Obesity control programmes should be implemented to prevent or delay the development of hypertension in rural China.

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Section: Discussionsupporting

confidence: 92%