Impact of Body Mass Index on Incident Hypertension and Diabetes in Chinese Asians, American Whites, and American Blacks: The People's Republic of China Study and the Atherosclerosis Risk in Communities Study

Abstract

Researchers have hypothesized that the impact of body mass index on chronic disease may be greater in Asians than in Whites; however, most studies are cross-sectional and have no White comparison group. The authors compared the associations with body mass index in Chinese Asians (n = 5,980), American Whites (n = 10,776), and American Blacks (n = 3,582) using prospective data from the People's Republic of China Study (1983-1994) and the Atherosclerosis Risk in Communities Study (1987-1998). Slopes of risk differences over body mass index levels were compared among the three ethnic groups in adjusted analyses. The authors found larger associations with body mass index in Chinese Asians compared with American Whites and Blacks for hypertension (p < 0.05). The increase in the incidence of hypertension associated with a one-unit increase in body mass index over approximately 8 years of follow-up was 2.5, 1.7, and 1.8 percentage points for Chinese Asians, American Whites, and American Blacks, respectively. For diabetes, the estimates were 1.7, 1.1, and 1.6 percentage points for the same groups- higher in Chinese Asians than in American Whites (p < 0.05) but similar between Chinese Asians and American Blacks. Given the ethnic differences in associations, the results support advocacy of public health and medical actions toward obesity prevention and treatment in China.

Body Mass Index Is Associated with Hypertension in Japanese Young Elderly Individuals: Findings of the New Integrated Suburban Seniority Investigation

“…Our findings are compatible with those of many previous studies across various cohorts reporting that being overweight/obese increases the risk of developing hypertension (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). The biological mechanisms involved in the development of hypertension associated with hyperadiposity have not been fully elucidated.…”

“…25.0 kg/m 2 (5); this proportion continues to increase. Previous studies have indicated that being overweight/obese (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) increases the risk of hypertension in general.…”

Race and Obesity in Adolescent Hypertension

“…10,11 Interestingly, some studies have found the opposite to be true, where the association of BMI with BP may be stronger in the Chinese-Asian population than in non-Asian populations. 12,13 It should be noted that these studies draw data from adults in mainland China, and therefore may not be analogous to the Asian-American population.…”

Association of genetic variants for susceptibility to obesity with type 2 diabetes in Japanese individuals

“…It has also been estimated that the absolute genetic variances for BMI and weight are greater in Europeans than in East Asians, according to an adolescent twin study [2]. From an epidemiological viewpoint, moreover, it has been hypothesised that the overall impact of obesity on type 2 diabetes is greater in Asians than in Europeans [21]. Accordingly, it is of interest to compare the genetic associations between populations of European descent and Japanese populations.…”