Abstract
冯宝玉,陈纪春,李莹,黄建凤,李建新,赵连成,曹杰,刘小清,黄辰,邓颖,阮连生,郭东双,俞玲,陈娜萦,杨睿海,杨小平,顾东风.中国成年人超重和肥胖与高血压发病关系的随访研究[J].Chinese journal of Epidemiology,2016,37(5):606-611
中国成年人超重和肥胖与高血压发病关系的随访研究
Relationship between overweight/obesity and hypertension among adults in China:a prospective study
Received:February 06, 2016  
DOI:10.3760/cma.j.issn.0254-6450.2016.05.004
KeyWord: 高血压  肥胖  发病风险  体质指数  队列研究
English Key Word: Hypertension  Obesity  Incidence  Body mass index  Cohort study
FundProject:国家"十一五"科技支撑计划(2006BAI01A01);国家"十二五"科技支撑计划(2011BAI11B03,2011BAI09B03);北京市自然科学基金(2015-BZJ01)
Author NameAffiliationE-mail
Feng Baoyu Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China  
Chen Jichun Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China chenjich@hotmail.com 
Li Ying Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China  
Huang Jianfeng Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China  
Li Jianxin Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China  
Zhao Liancheng Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China  
Cao Jie Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China  
Liu Xiaoqing Department of Epidemiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangzhou 510080, China  
Huang Chen Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China  
Deng Ying Department of Chronic and Non-communicable Disease Control and Prevention, Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610044, China  
Ruan Liansheng Department of Cardiology, Putuo General Hospital, Putuo Cardiovascular Institute of Zhejiang Province, Zhoushan 316100, China  
Guo Dongshuang Department of Cardiovascular Diseases, Yuxian People's Hospital of Shanxi Province, Yangquan 045100, China  
Yu Ling Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350001, China  
Chen Naying Non-communicable Disease Control and Prevention, Guangxi Zhuang Automous Region Center for Disease Control and Prevention, Nanning 530021, China  
Yang Ruihai Hanzhong Cardiovascular Institute of Shunaxi Province, Hanzhong 723000, China  
Yang Xiaoping Non-communicable Disease Control and Prevention, Jintan Center for Disease Control and Prevention, Changzhou 213200, China  
Gu Dongfeng Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China  
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Abstract:
      目的 探讨中国成年人超重和肥胖与高血压发病的关系。方法 研究对象来自中国心血管病流行病学多中心协作研究和中国心血管健康多中心合作研究,两项研究分别于1998年和2000-2001年开展基线调查,并在2007-2008年开展统一的健康状况随访。共纳入13739名研究对象进入最终分析,按照BMI将研究对象分成四组:低体重组(<18.5 kg/m2)、正常体重组(18.5~23.9 kg/m2)、超重组(24.0~27.9 kg/m2)和肥胖组(≥28.0 kg/m2)。计算四组人群年龄标化的高血压累积发病率;并以正常体重组为参照,使用广义线性回归模型计算其他三组高血压发病风险RR值及其95%CI结果 本研究平均随访8.1年,确诊新发高血压4271例,其中男性2012例,女性2259例。低体重组、正常体重组、超重组和肥胖组的年龄标化高血压累积发病率分别为21.6%、30.6%、42.4%和50.8%,随着BMI的升高而升高(趋势P<0.001)。以正常体重组为参照调整协变量,男性低体重组、超重组和肥胖组的RR值(95%CI)分别为0.78(0.64~0.95)、1.22(1.13~1.30)和1.28(1.16~1.42);女性分别为0.89(0.77~1.03)、1.16(1.09~1.23)和1.28(1.18~1.38)。结论 我国超重和肥胖者的高血压发病风险明显升高,应加强对超重和肥胖人群的高血压防控。
English Abstract:
      Objective To evaluate the influence of overweight/obesity on the incidence of hypertension among adults in China. Methods The subjects of this prospective study were 13 739 Chinese adults aged 35-74 years recruited at the baseline surveys of China Multicenter Collaborative Study of Cardiovascular Disease Epidemiology and International Collaborative Study of Cardiovascular Disease in Asian. Baseline surveys were conducted in 1998 and during 2000-2001, respectively, and the follow-up was conducted during 2007-2008. According to the body mass index, the subjects were divided into four groups:underweight group (<18.5 kg/m2), normal weight group (18.5-23.9 kg/m2), overweight group (24.0-27.9 kg/m2) and obesity group (≥28.0 kg/m2). Age-standardized cumulative incidence of hypertension was calculated for each group, respectively. The relative risks (RRs) and 95% confidence intervals (CIs) for the incidence of hypertension of underweight, overweight and obesity groups were estimated by using generalized linear regression model with normal weight group as reference. Results During 8.1 years of follow-up, 4 271 hypertension cases were detected (2 012 in men and 2 259 in women). Age-standardized cumulative incidence of hypertension for the underweight, normal weight, overweight and obesity groups were 20.3%, 30.9%, 43.6% and 50.8% in men, respectively; and 22.9%, 30.4%, 41.1% and 50.8% in women, respectively. Compared with the normal weight group, multivariate-adjusted RR (95%CI) for the incidence of hypertension in underweight, overweight and obesity groups were 0.78 (0.64-0.95), 1.22 (1.13-1.30) and 1.28 (1.16-1.42) in men, respectively; and 0.89 (0.77-1.03), 1.16 (1.09-1.23) and 1.28 (1.18-1.38) in women, respectively. The overweight and obese subjects had higher risk for the incidence of hypertension, with the population attributable risk proportion of 7.4% in men and 8.8% in women, respectively. Conclusion Overweight or obese people are at an increased risk of developing hypertension, thus prevention and control of overweight/obesity are needed to reduce hypertension incidence among adults in China.
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