Trajectories of mid-life to elderly adulthood BMI and incident hypertension: the China Health and Nutrition Survey

Zeng, Qinghui; Sun, Lin

doi:10.1136/bmjopen-2020-047920

Cited by 10 publications

(13 citation statements)

References 35 publications

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“…Trajectories of BMI and WC allow the assessment of dynamic patterns of BMI and WC and the impact on hypertension [ 22 ]. Based on the findings of previous studies on BMI trajectories in adults, trajectories of rapidly increasing BMI in Chinese [ 23 ] and trajectories of maintaining high BMI levels in Chinese [ 24 ] and in Canadians [ 25 ] are associated with an increased risk of hypertension. Cheng et al [ 26 ] found that sharply increasing trajectories of WC during adolescence were associated with higher risks of incident hypertension in Chinese.…”

Section: Introductionmentioning

confidence: 99%

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

Wang

Song²,

et al. 2023

Nutrients

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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.

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Section: Introductionmentioning

confidence: 99%

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

Wang

Song²,

et al. 2023

Nutrients

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“…Other study conducted by Zeng et al (2021), which also assessed various BMI trajectories in relation to the incidence of HBP, the adjusted HR for HBP was compared to the stable low BMI class. The findings revealed that the sharply increasing BMI class had an adjusted HR of 1.3 (95%CI: 1.1-1.5), while the stable high BMI class exhibited an adjusted HR of 1.5 (95%CI: 1.3-1.7).…”

Section: Discussionmentioning

confidence: 99%

“…However, assessing only one BMI measure throughout a person's life course may not provide an accurate representation of their BMI changes over time. For this reason, researchers have proposed to study BMI trajectories, that are patterns of changing in BMI over time (De Rubeis et al, 2020; VanWagner et al, 2018; Zeng et al, 2021). The trajectory of BMI is influenced by a range of factors, including genetics, environmental factors, and lifestyle factors such as diet and physical activity (PA), and medical conditions (Clarke et al, 2009; Liu et al, 2018; Werneck et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Risk assessment of obesity‐related noncommunicable diseases through body mass index trajectories in adulthood: NHANES 2007–2018

dos Santos Pereira,

dos Santos,

Vieira Pastorello

et al. 2023

American J Hum Biol

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AimTo assess the impact of adult body mass index (BMI) trajectories on the risk of obesity‐related noncommunicable diseases (NCDs) in the U.S. adults after adjustment for sociodemographic and lifestyle factors.MethodsData were extracted from the National Health and Nutrition Examination Survey conducted from 2007 to 2018, including male and female participants aged 29–59 years. Rao‐Scott adjusted chi‐square was employed to detect associations between categorical variables in descriptive analyses. Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) for NCDs and BMI trajectories, adjusted for sociodemographic and lifestyle factors. Kaplan–Meier curves illustrated the cumulative incidence over time.ResultsAnalyses were carried out on 15 721 participants and revealing significant differences among BMI trajectories in terms of demographic, lifestyle, and health characteristics. The overall prevalence of NCDs was 28.0% (95%CI:26.6–28.9). The cumulative incidence over time was higher in the high increase, moderate increase, and mixed trajectory groups, with a correspondingly higher cumulative risk (p < 0.001). Non‐overweight trajectory was considered reference category in Cox models. The BMI trajectories were independently associated with an increased risk of NCDs, even after adjusting for potential confounders (HR: 1.7; 95%CI: 1.4–1.9 for moderate increase; HR: 3.6; 95%CI: 3.2–4.1 for high increase; and HR: 2.4; 95%CI: 2.1–2.7, for mixed). Furthermore, differences between males and females were also observed.ConclusionThe transition to and persistence of obesity into adulthood increases the risk of NCDs. The implementation of targeted interventions with long‐term monitoring of BMI may be beneficial in the prevention of future obesity‐related NCDs.

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“…After excluding 141 duplicates and 8,160 unrelated articles based on screening of the title and abstract, 112 full-text publications were reviewed for eligibility. Ultimately, 18 articles provided sufficient information and were considered qualified for our meta-analysis (6,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). The 18 cohort studies included 89,094 participants.…”

Section: Study Selectionmentioning

confidence: 99%

Association of body mass index trajectory and hypertension risk: A systematic review of cohort studies and network meta-analysis of 89,094 participants

Tan

Long²,

Ma³

et al. 2023

Front. Cardiovasc. Med.

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IntroductionBody mass index (BMI) trajectories, such as non-linear time trends and nonlinear changes in BMI with age, can provide information on the underlying temporal health patterns. The relationship between BMI trajectories and the risk of hypertension remains controversial.MethodsPubMed, Embase, Cochrane, Scopus, and Web of Science databases were searched from their inception to January 31, 2022. We categorized BMI trajectories as “Stable high,” “table normal,” “Stable low,” “Fluctuated (sharp increase),” and “Fluctuated (elevated-decrease).” The main outcome was the relative risk for the prevalence of hypertension in the different BMI trajectories. Potential sources of heterogeneity were examined using meta-regression and subgroup analysis. A publication bias test and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were also used.ResultsThe 18 cohort studies included 89,094 participants. Compared with the “Stable normal” trajectory, “Stable high,” “Fluctuated (sharp increase),” and “Fluctuated (elevated-decrease)” trajectories were associated with an increased relative risk of hypertension: [RR (95% CI)]: 1.80 (1.29 2.50), p < 0.001; 1.53 (1.27 1.83), p < 0.001; 1.30 (1.24 1.37), p = 0.001, respectively. The “Stable low” trajectory was associated with a reduced risk of hypertension [0.83 (0.79 0.83), p < 0.001]. The “Stable high” trajectory (surface under the cumulative ranking curve = 88.1%) had the highest probability of developing hypertension in the population. The certainty of the evidence for direct comparisons of the incidence of hypertension between various BMI trajectories was generally very low.ConclusionOur findings suggested that “Stable high,” “Fluctuated (sharp increase),” and “Fluctuated (elevated-decrease)” trajectories were associated with an increased relative risk of hypertension, with the “Stable high” trajectory most likely associated with hypertension.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=308575], identifier [CRD42022308575].

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Trajectories of mid-life to elderly adulthood BMI and incident hypertension: the China Health and Nutrition Survey

Cited by 10 publications

References 35 publications

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

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

Risk assessment of obesity‐related noncommunicable diseases through body mass index trajectories in adulthood: NHANES 2007–2018

Association of body mass index trajectory and hypertension risk: A systematic review of cohort studies and network meta-analysis of 89,094 participants

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