Limits...
Body Mass Index and the Risk of Cardiovascular and All-Cause Mortality Among Patients With Hypertension: A Population-Based Prospective Cohort Study Among Adults in Beijing, China

View Article: PubMed Central - PubMed

ABSTRACT

Background: Studies on the association between body mass index (BMI) and death risk among patients with hypertension are limited, and the results are inconsistent. We investigated the association between BMI and cardiovascular disease (CVD) and all-cause mortality among hypertensive patients in a population of Beijing, China.

Methods: We conducted a prospective cohort study of 2535 patients with hypertension aged 40 to 91 years from Beijing, China. Participants with a history of CVD at baseline were excluded from analysis. Cox proportional hazards regression models were used to estimate the association of different levels of BMI stratification with CVD and all-cause mortality.

Results: During a mean follow-up of 8.1 years, 486 deaths were identified, including 233 cases of CVD death. The multivariable-adjusted hazards ratios for all-cause mortality associated with BMI levels (<20, 20–22, 22–24, 24–26 [reference group], 26–28, 28–30, and ≥30 kg/m2) were 2.03 (95% confidence interval [CI], 1.48–2.78), 1.61 (95% CI, 1.18–2.20), 1.30 (95% CI, 0.95–1.78), 1.00 (reference), 1.12 (95% CI, 0.77–1.64), 1.33 (95% CI, 0.90–1.95), and 1.66 (95% CI, 1.10–2.49), respectively. When stratified by age, sex, or smoking status, the U-shaped association was still present in each subgroup (P > 0.05 for all interactions). Regarding the association of BMI with CVD mortality, a U-shaped trend was also observed.

Conclusions: The present study showed a U-shaped association of BMI with CVD and all-cause mortality among patients with hypertension. A lowest risk of all-cause mortality was found among hypertensive patients with BMI between 24 and 26 kg/m2.

No MeSH data available.


Predicted all-cause and CVD mortality with 95% confidence intervals based on the best fitting fractional polynomial models in the total participants (Figure 1: all-cause mortality; Figure 2: CVD mortality) and after excluding those who were censored during the first 2 years of follow-up (Figure 3: all-cause mortality; Figure 4: CVD mortality).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5121434&req=5

fig01: Predicted all-cause and CVD mortality with 95% confidence intervals based on the best fitting fractional polynomial models in the total participants (Figure 1: all-cause mortality; Figure 2: CVD mortality) and after excluding those who were censored during the first 2 years of follow-up (Figure 3: all-cause mortality; Figure 4: CVD mortality).

Mentions: When BMI was considered as a continuous variable, we found that a fractional polynomial regression model of second-degree (FP2) significantly improved a linear model regarding the relationship between BMI and all-cause mortality (P = 0.027), indicating a U-shaped association of BMI with all-cause mortality, with a nadir of the U-shape at BMIs of 24 to 26 kg/m2 (Figure 1). As for the relationship between BMI and CVD mortality, neither fractional polynomial regression model of second-degree (FP2) nor the model of first-degree (FP1) significantly improve a linear model (both P > 0.05); however, a trend toward a U-shaped association existed between BMI and CVD mortality (Figure 2).


Body Mass Index and the Risk of Cardiovascular and All-Cause Mortality Among Patients With Hypertension: A Population-Based Prospective Cohort Study Among Adults in Beijing, China
Predicted all-cause and CVD mortality with 95% confidence intervals based on the best fitting fractional polynomial models in the total participants (Figure 1: all-cause mortality; Figure 2: CVD mortality) and after excluding those who were censored during the first 2 years of follow-up (Figure 3: all-cause mortality; Figure 4: CVD mortality).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121434&req=5

fig01: Predicted all-cause and CVD mortality with 95% confidence intervals based on the best fitting fractional polynomial models in the total participants (Figure 1: all-cause mortality; Figure 2: CVD mortality) and after excluding those who were censored during the first 2 years of follow-up (Figure 3: all-cause mortality; Figure 4: CVD mortality).
Mentions: When BMI was considered as a continuous variable, we found that a fractional polynomial regression model of second-degree (FP2) significantly improved a linear model regarding the relationship between BMI and all-cause mortality (P = 0.027), indicating a U-shaped association of BMI with all-cause mortality, with a nadir of the U-shape at BMIs of 24 to 26 kg/m2 (Figure 1). As for the relationship between BMI and CVD mortality, neither fractional polynomial regression model of second-degree (FP2) nor the model of first-degree (FP1) significantly improve a linear model (both P > 0.05); however, a trend toward a U-shaped association existed between BMI and CVD mortality (Figure 2).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Studies on the association between body mass index (BMI) and death risk among patients with hypertension are limited, and the results are inconsistent. We investigated the association between BMI and cardiovascular disease (CVD) and all-cause mortality among hypertensive patients in a population of Beijing, China.

Methods: We conducted a prospective cohort study of 2535 patients with hypertension aged 40 to 91 years from Beijing, China. Participants with a history of CVD at baseline were excluded from analysis. Cox proportional hazards regression models were used to estimate the association of different levels of BMI stratification with CVD and all-cause mortality.

Results: During a mean follow-up of 8.1 years, 486 deaths were identified, including 233 cases of CVD death. The multivariable-adjusted hazards ratios for all-cause mortality associated with BMI levels (<20, 20–22, 22–24, 24–26 [reference group], 26–28, 28–30, and ≥30 kg/m2) were 2.03 (95% confidence interval [CI], 1.48–2.78), 1.61 (95% CI, 1.18–2.20), 1.30 (95% CI, 0.95–1.78), 1.00 (reference), 1.12 (95% CI, 0.77–1.64), 1.33 (95% CI, 0.90–1.95), and 1.66 (95% CI, 1.10–2.49), respectively. When stratified by age, sex, or smoking status, the U-shaped association was still present in each subgroup (P > 0.05 for all interactions). Regarding the association of BMI with CVD mortality, a U-shaped trend was also observed.

Conclusions: The present study showed a U-shaped association of BMI with CVD and all-cause mortality among patients with hypertension. A lowest risk of all-cause mortality was found among hypertensive patients with BMI between 24 and 26 kg/m2.

No MeSH data available.