BMI and risk of all-cause mortality in normotensive and hypertensive adults: the rural Chinese cohort study. Issue 17 (16th December 2021)

• Record Type: Journal Article
• Authors: Zhou, Qionggui; Liu, Xuejiao; Zhao, Yang; Qin, Pei; Ren, Yongcheng; Liu, Dechen; Liu, Leilei; Chen, Xu; Liu, Feiyan; Cheng, Cheng; Guo, Chunmei; Li, Quanman; Tian, Gang; Wu, Xiaoyan; Qie, Ranran; Han, Minghui; Huang, Shengbing; Xu, Lidan; Zhang, Ming; Hu, Dongsheng
• Is Part Of: Public health nutrition. Volume 24:Issue 17(2021)
• Page Start: 5805
• Page End: 5814
• Publication Date: 2021-12-16
• Subjects: BMI -- All-cause mortality -- Hypertension -- Obesity paradox; Nutrition -- Periodicals; Nutrition policy -- Periodicals; Public health -- Periodicals; 613.2
• DOI: 10.1017/S1368980021001592
• Languages: English
• ISSNs: 1368-9800

Abstract

Abstract: Objective: The impact of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to examine the moderation effect of hypertension on the BMI–mortality association using a rural Chinese cohort. Design: In this cohort study, we investigated the incident of mortality according to different BMI categories by hypertension status. Setting: Longitudinal population-based cohort. Participants: 17 262 adults ≥18 years were recruited from July to August of 2013 and July to August of 2014 from a rural area in China. Results: During a median 6-year follow-up, we recorded 1109 deaths (610 with and 499 without hypertension). In adjusted models, as compared with BMI 22–24 kg/m 2, with BMI ≤ 18, 18–20, 20–22, 24–26, 26–28, 28–30 and >30 kg/m 2, the hazard ratios for mortality in normotensive participants were 1·92 (95% CI 1·23, 3·00), 1·44 (95% CI 1·01, 2·05), 1·14 (95% CI 0·82, 1·58), 0·96 (95% CI 0·70, 1·31), 0·96 (95% CI 0·65, 1·43), 1·32 (95% CI 0·81, 2·14) and 1·32 (95% CI 0·74, 2·35), respectively, and in hypertensive participants were 1·85 (95% CI 1·08, 3·17), 1·67 (95% CI 1·17, 2·39), 1·29 (95% CI 0·95, 1·75), 1·20 (95% CI 0·91, 1·58), 1·10 (95% CI 0·83, 1·46), 1·10 (95% CI 0·80, 1·52) and 0·61 (95% CI 0·40, 0·94), respectively. The risk of mortality was lower in individuals with hypertension with overweight or obesity v . normal weight, especially in older hypertensives (≥60 years old). Sensitivity analyses gave consistent results for both normotensive and hypertensive participants. Conclusions: Low BMI was significantly associated with increased risk of all-cause mortality regardless of hypertension status in rural Chinese adults, but high BMI decreased the mortality risk among individuals with hypertension, especially in older hypertensives.