不同体质量指数对非高血压人群进展为高血压病的影响

The impact of different body mass index on the progression to hypertension in non-hypertensive population

目的探讨不同体质量指数(body mass index,BMI)对非高血压人群进展为高血压病的影响。方法选择参加年度体检并完成至少2次的体检者,根据基线BMI分为低体质量组(BMI<18.5)、正常体质量组(18.5≤BMI<24)、超重组(24≤BMI<28)和肥胖组(BMI≥28),比较各组的临床特点及高血压病发病率的差异。进一步根据基线不同血压水平将体检者分为正常血压组和正常高值组两个亚组,采用多因素COX回归分析基线不同血压下BMI对高血压进展的影响。结果基线入选非高血压者23 665人,平均随访3.6年后,共有2 502人进展为高血压病。低体质量组、正常体质量组、超重组和肥胖组的高血压病发病率分别为2.80%、6.41%、17.88%和27.84%,从低体质量组到肥胖组呈递增趋势(P<0.01)。多因素Cox回归分析结果显示,在校正其他混杂因素后,高血压发病风险从正常体质量组到肥胖组依次升高。其中超重组、肥胖组的高血压发病风险分别是正常体质量组的1.22倍(95%CI 1.12~1.34,P<0.01)、1.35倍(95%CI 1.19~1.53,P<0.01)。无论在正常血压组还是正常高值组,这种高血压发病风险从正常体质量组到肥胖组依次升高的趋势均存在。结论随基线BMI的增加,高血压病发病率和发病风险升高。

AIM To investigate the impact of different body mass indexes on progression to hypertension in non-hypertensive population. METHODS Subjects who participated in annual physical examinations and completed a minimum of 2 times were selected and they were divided into low weight group （ BMI 〈 18.5）, normal weight group （18.5≤BMI 〈24）, overweight group （24≤BMI 〈28） and obesity group （BMI≥28） , according to baseline BMI. Clinical features were evaluated and incidence of hypertension was compared among four groups. According to different blood pressures at baseline, the subjects were divided into normal blood pressure group and high-normal blood pressure group. Multivariate Cox regression was used to analyze the effect of BMI at different blood pressure at baseline on the progression of hypertension. RESULTS 23 665 non-hypertensive subjects at baseline were enrolled. A total of 2 502 subjects developed hypertension after a mean follow-up of 3. 6 years. The incidence of hypertension increased from low weight group to obesity group and were 2. 80%, 6. 41%, 17. 88%, 27. 84% in the low weight group, normal weight group, overweight group, and obesity group, respectively. Multivariate Cox regression analysis showed that the risk of hypertension increased from the normal weight group to the obesity group after adjusted for other confounding factors. The risk of hypertension in the overweight group and the obesity group were 1.22 times and 1.35 times higher than the normal weight group. This trend of increasing risk of hypertension from normal weight group to obesity group existed both in the normal group and the high normal group. CONCLUSION The incidence and risk of hypertension increase with increment of baseline body mass index.