体重指数对10年累积高血压发病危险的预测作用

摘要

Objective To explore the association between body mass index(BMI) and ten-year accumulative risk of hypertension. Methods A prospective study of relationship between blood pressure and other traditional risk factors was carried out in a cohort with 2115 people aged 35-64 years old involved, in 1992 and 2002. The association between baseline BMI level and a ten-year accumulative risk of hypertension was analyzed. Results The ten-year accumulative incidence rate of hypertension was 34.8%, and increased with the elevated baseline BMI level in both genders (P<0.001). Similar changing trends were observed in both age groups of 45-54 year and 55-64 year olds (P<0.05). Multivariable OR (95%CI) of accumulative incident hypertension in the highest BMI tertile(≥128 kg/m2) was 3.569 higher (2.559 to 4.977) when compared to the lowest (<24 kg/m2). The ten-year accumulative risk of hypertension increased 17.5% with elevation of baseline BMI level by 1 kg/m2. The ten-year accumulative incidence rate of hypertension was 22.0% in the subjects with normal BMI and 56.3% in those with obesity, both in 1992 and 2002. Conclusion BMI appeared to be an independent risk factor for hypertension, and the risk of incident hypertension increased with elevated BMI level.%目的 探讨北京地区队列人群基线(1992年)BMI水平及10年(1992-2002年)BMI水平的变化与高血压发生的关系.方法 采用前瞻性队列研究的方法,于1992年对北京大学社区和首都钢铁公司地区35～64岁人群进行基线心血管病危险因素调查,并持续10年对心血管病的发病情况进行随访.在2002年对相同人群再次进行了危险因素调查.两次调查资料完整,且对基线无高血压的2115人进行分析.结果 调查的35～64岁人群10年高血压累积发病率为34.8%.随着基线BMI水平的增加,10年后高血压的累积发病率呈增加趋势(P<0.001),男女两性的变化趋势一致.在45～54岁组和55～64岁组,随着基线BMI水平的增加,10年高血压的累积发病率也呈线性增加趋势(P<0.05).多因素logistic回归分析显示,BMI≥28 kg/m2组的高血压发病危险是BMI<24 kg/m2组的3.6倍;10年BMI水平每增加1 kg/m2,累积发生高血压的危险增加17.5%.1992年和2002年BMI均正常者中有22.0%的人发生高血压,1992年和2002年BMI均判为肥胖者中有56.3%的人发生高血压.结论 BMI是高血压发病的一个独立危险因素,随着基线BMI水平的增加高血压的发病危险也增加.