Multiple Trajectories of Body Mass Index and Waist Circumference and Their Associations with Hypertension and Blood Pressure in Chinese Adults from 1991 to 2018: A Prospective Study

Abstract

Body mass index (BMI) and waist circumference (WC) have been suggested to be involved in the etiology of hypertension. The present study aimed to determine multiple trajectories of BMI and WC, then examined their associations with the risks of hypertension and high blood pressure in Chinese adults. The study used China Health and Nutrition Survey data from 1991 to 2018. The sample included 9651 adults aged 18 years or older. We used group-based multi-trajectory modeling to identify trajectories. We estimated the relationships between the trajectories and the risks of hypertension with a Cox proportional hazards regression model and the trajectories’ relationships with blood pressure levels with a generalized linear model. We identified four trajectories for each gender: low stable BMI, low increasing WC (group 1); medium increasing BMI, medium increasing WC (group 2); increasing BMI to overweight, increasing WC to central obesity (group 3), increasing BMI to obesity, increasing central obesity WC (group 4). Group 1 was the reference group. Among males in groups 2, 3, and 4, the adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) of hypertension were 1.30 (1.15–1.48), 1.86 (1.58–2.18), and 2.60 (2.02–3.34), respectively. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of males in group 4 increased by 11.90 mm of mercury (mmHg) and 7.75 mmHg, respectively. Among females in groups 2, 3, and 4, the HR and 95% CI of hypertension were 1.35 (1.18–1.54), 1.92 (1.62–2.26), and 2.37 (1.85–3.03), respectively. The SBP and DBP of females in group 4 increased by 8.84 mmHg and 5.79 mmHg, respectively. These data indicated that increases in BMI and WC were associated with unfavorable hypertension risks. Attention to both BMI and WC trajectories has the potential to prevent hypertension.

Multi-trajectories of body mass index, waist circumference, gut microbiota, and incident dyslipidemia: a 27-year prospective study

“…This grouping can not only re ect the status of obesity and central obesity, but also show the baseline obesity level and long-term change trends simultaneously. To the best of our knowledge, only one study [24] reported multi-trajectory of BMI and WC, and its results were similar to our study. In addition, the BMI trajectories [25,26] and WC trajectories [27] derived from large samples of adults only also showed four increasing trend groups.…”

Reticulon 3 regulates sphingosine‐1‐phosphate synthesis in endothelial cells to control blood pressure

“…Our previous study reported that overexpression of RTN3 may partly lead to HTG and obesity, which are important factors in the development of secondary hypertension. 12 , 17 To further investigate the association between RTN3 and hypertension, we enrolled 18 healthy controls and 56 primary hypertension patients with normal triglyceride levels (<1.7 mmol/L) and body mass index (18.5–24 kg/m 2 ) to exclude the effects of HTG and obesity. Enzyme‐linked immunosorbent assay (ELISA) detection exhibited higher RTN3 levels in part patients (Figure 1A and Table 1 ).…”

Are ambulatory blood pressure parameters associated more with central adiposity than with total adiposity? Results of the ELSA-Brasil study

“…Another limitation is that, in this study, HTN classification by casual BP was based on a one-time measurement (average of two consecutive measurements), compared with 2–3 different visits to confirm sustained elevations in BP in clinical practice ( 56 ). However, this procedure is widely used in epidemiological studies, especially those with large sample sizes ( 57 – 59 ). Furthermore, HTN classification was used only in the descriptive analysis and casual BP levels were included as a secondary outcome in our study to compare results with multiple BP readings from ABPM over a 24-hour period.…”