Body weight, weight change and the risk of cardiovascular disease in patients with hypertension: a primary-care cohort study.
Journal
International journal of obesity (2005)
ISSN: 1476-5497
Titre abrégé: Int J Obes (Lond)
Pays: England
ID NLM: 101256108
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
04
12
2022
accepted:
26
06
2023
revised:
12
06
2023
medline:
21
8
2023
pubmed:
7
7
2023
entrez:
6
7
2023
Statut:
ppublish
Résumé
Obesity and cardiovascular disease (CVD) often co-occur. However, the effects of excessive body weight and weight change on CVD in patients with hypertension are not clearly established. We examined the associations of BMI, weight change and the risk of CVD in patients with hypertension. Our Data were drawn from the medical records of primary-care institutions in China. A total of 24,750 patients with valid weight measurements attending primary healthcare centers were included. Body weight were grouped in BMI categories of underweight ( < 18.5 kg/m After multivariable adjustment, patients with obesity were related to higher risks of CVD (HR = 1.48, 95% CI: 1.19-1.85). Higher risks were seen in participants with loss ≥4% and gain >4% of body weight compared to stable weight (loss ≥4%: HR = 1.33, 95% CI: 1.04-1.70; gain >4%: HR = 1.36, 95% CI: 1.04-1.77). Obesity and weight change of loss ≥4% and gain >4% were related to higher risks of CVD. Close monitoring and appropriate interventions aimed at achieving an optimal weight are needed to prevent adverse cardiovascular outcomes for patients with hypertension.
Sections du résumé
BACKGROUND/OBJECTIVES
Obesity and cardiovascular disease (CVD) often co-occur. However, the effects of excessive body weight and weight change on CVD in patients with hypertension are not clearly established. We examined the associations of BMI, weight change and the risk of CVD in patients with hypertension.
SUBJECTS/METHODS
Our Data were drawn from the medical records of primary-care institutions in China. A total of 24,750 patients with valid weight measurements attending primary healthcare centers were included. Body weight were grouped in BMI categories of underweight ( < 18.5 kg/m
RESULTS
After multivariable adjustment, patients with obesity were related to higher risks of CVD (HR = 1.48, 95% CI: 1.19-1.85). Higher risks were seen in participants with loss ≥4% and gain >4% of body weight compared to stable weight (loss ≥4%: HR = 1.33, 95% CI: 1.04-1.70; gain >4%: HR = 1.36, 95% CI: 1.04-1.77).
CONCLUSION
Obesity and weight change of loss ≥4% and gain >4% were related to higher risks of CVD. Close monitoring and appropriate interventions aimed at achieving an optimal weight are needed to prevent adverse cardiovascular outcomes for patients with hypertension.
Identifiants
pubmed: 37414876
doi: 10.1038/s41366-023-01335-z
pii: 10.1038/s41366-023-01335-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
848-854Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature Limited.
Références
Mills KT, Bundy JD, Kelly TN, Reed JE, Kearney PM, Reynolds K, et al. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation. 2016;134:441–50.
pubmed: 27502908
pmcid: 4979614
doi: 10.1161/CIRCULATIONAHA.115.018912
Mittal BV, Singh AK. Hypertension in the developing world: challenges and opportunities. Am J Kidney Dis. 2010;55:590–8.
pubmed: 19962803
doi: 10.1053/j.ajkd.2009.06.044
Qamar A, Braunwald E. Treatment of hypertension: addressing a global health problem. JAMA. 2018;320:1751–2.
pubmed: 30398610
doi: 10.1001/jama.2018.16579
Haider AW, Larson MG, Franklin SS, Levy D. Systolic blood pressure, diastolic blood pressure, and pulse pressure as predictors of risk for congestive heart failure in the Framingham Heart Study. Ann Intern Med. 2003;138:10–16.
pubmed: 12513039
doi: 10.7326/0003-4819-138-1-200301070-00006
Fuchs FD, Whelton PK. High blood pressure and cardiovascular disease. Hypertension. 2020;75:285–92.
pubmed: 31865786
doi: 10.1161/HYPERTENSIONAHA.119.14240
Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, Nichols M. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J. 2016;37:3232–45.
pubmed: 27523477
doi: 10.1093/eurheartj/ehw334
Leggio M, Lombardi M, Caldarone E, Severi P, D’Emidio S, Armeni M, et al. The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res. 2017;40:947–63.
pubmed: 28978986
doi: 10.1038/hr.2017.75
Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, et al. Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens. 2014;32:3–15.
pubmed: 24270181
doi: 10.1097/HJH.0000000000000065
Landsberg L, Aronne LJ, Beilin LJ, Burke V, Igel LI, Lloyd-Jones D, et al. Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment–a position paper of the The Obesity Society and The American Society of Hypertension. Obesity. 2013;21:8–24.
pubmed: 23401272
doi: 10.1002/oby.20181
McLaughlin VV, Archer SL, Badesch DB, Barst RJ, Farber HW, Lindner JR, et al. ACCF/AHA 2009 expert consensus document on pulmonary hypertension a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association. J Am Coll Cardiol. 2009;53:1573–619.
pubmed: 19389575
doi: 10.1016/j.jacc.2009.01.004
Dwivedi AK, Dubey P, Cistola DP, Reddy SY. Association Between Obesity and Cardiovascular Outcomes: Updated Evidence from Meta-analysis Studies. Curr Cardiol Rep. 2020;22:25.
pubmed: 32166448
doi: 10.1007/s11886-020-1273-y
de Simone G, Wachtell K, Palmieri V, Hille DA, Beevers G, Dahlöf B, et al. Body build and risk of cardiovascular events in hypertension and left ventricular hypertrophy: the LIFE (Losartan Intervention For Endpoint reduction in hypertension) study. Circulation. 2005;111:1924–31.
pubmed: 15837945
doi: 10.1161/01.CIR.0000161799.91577.0A
Xu W, Shubina M, Goldberg SI, Turchin A. Body mass index and all-cause mortality in patients with hypertension. Obesity. 2015;23:1712–20.
pubmed: 26179058
doi: 10.1002/oby.21129
Lu J, Lu Y, Wang X, Li X, Linderman GC, Wu C, et al. Prevalence, awareness, treatment, and control of hypertension in China: data from 1·7 million adults in a population-based screening study (China PEACE Million Persons Project). Lancet. 2017;390:2549–58.
pubmed: 29102084
doi: 10.1016/S0140-6736(17)32478-9
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63.
doi: 10.1016/S0140-6736(03)15268-3
Wallace JI, Schwartz RS, LaCroix AZ, Uhlmann RF, Pearlman RA. Involuntary weight loss in older outpatients: incidence and clinical significance. J Am Geriatr Soc. 1995;43:329–37.
pubmed: 7706619
doi: 10.1111/j.1532-5415.1995.tb05803.x
Lee AK, Woodward M, Wang D, Ohkuma T, Warren B, Sharrett AR, et al. The Risks of Cardiovascular Disease and Mortality Following Weight Change in Adults with Diabetes: Results from ADVANCE. J Clin Endocrinol Metab. 2020;105:152–62.
pubmed: 31588504
doi: 10.1210/clinem/dgz045
Hu J, Xu H, Zhu J, Zhang J, Li J, Chen L, et al. Association between body mass index and risk of cardiovascular disease-specific mortality among adults with hypertension in Shanghai, China. Aging. 2021;13:6866–77.
pubmed: 33621195
pmcid: 7993713
doi: 10.18632/aging.202543
Khan SS, Ning H, Wilkins JT, Allen N, Carnethon M, Berry JD, et al. Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity. JAMA Cardiol. 2018;3:280–7.
pubmed: 29490333
pmcid: 5875319
doi: 10.1001/jamacardio.2018.0022
Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, et al. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021;143:e984–e1010.
pubmed: 33882682
pmcid: 8493650
doi: 10.1161/CIR.0000000000000973
Riaz H, Khan MS, Siddiqi TJ, Usman MS, Shah N, Goyal A, et al. Association Between Obesity and Cardiovascular Outcomes: A Systematic Review and Meta-analysis of Mendelian Randomization Studies. JAMA Netw Open. 2018;1:e183788.
pubmed: 30646365
pmcid: 6324374
doi: 10.1001/jamanetworkopen.2018.3788
de Simone G, Pasanisi F, Ferrara AL, Roman MJ, Lee ET, Contaldo F, et al. Relative fat-free mass deficiency and left ventricular adaptation to obesity: the Strong Heart Study. Int J Cardiol. 2013;168:729–33.
pubmed: 23063139
doi: 10.1016/j.ijcard.2012.09.055
Kuch B, Hense HW, Gneiting B, Döring A, Muscholl M, Bröckel U, et al. Body composition and prevalence of left ventricular hypertrophy. Circulation. 2000;102:405–10.
pubmed: 10908212
doi: 10.1161/01.CIR.102.4.405
Zhai AB, Haddad H. The impact of obesity on heart failure. Curr Opin Cardiol. 2017;32:196–202.
pubmed: 28092289
doi: 10.1097/HCO.0000000000000370
Engeli S, Feldpausch M, Gorzelniak K, Hartwig F, Heintze U, Janke J, et al. Association between adiponectin and mediators of inflammation in obese women. Diabetes. 2003;52:942–7.
pubmed: 12663465
doi: 10.2337/diabetes.52.4.942
Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C-reactive protein levels in overweight and obese adults. JAMA. 1999;282:2131–5.
pubmed: 10591334
doi: 10.1001/jama.282.22.2131
Traupe T, Lang M, Goettsch W, Münter K, Morawietz H, Vetter W, et al. Obesity increases prostanoid-mediated vasoconstriction and vascular thromboxane receptor gene expression. J Hypertens. 2002;20:2239–45.
pubmed: 12409963
doi: 10.1097/00004872-200211000-00024
Golia E, Limongelli G, Natale F, Fimiani F, Maddaloni V, Pariggiano I, et al. Inflammation and cardiovascular disease: from pathogenesis to therapeutic target. Curr Atheroscler Rep. 2014;16:435.
pubmed: 25037581
doi: 10.1007/s11883-014-0435-z
Lovren F, Teoh H, Verma S. Obesity and atherosclerosis: mechanistic insights. Can J Cardiol. 2015;31:177–83.
pubmed: 25661552
doi: 10.1016/j.cjca.2014.11.031
Jayedi A, Rashidy-Pour A, Soltani S, Zargar MS, Emadi A, Shab-Bidar S. Adult weight gain and the risk of cardiovascular disease: a systematic review and dose-response meta-analysis of prospective cohort studies. Eur J Clin Nutr. 2020;74:1263–75.
pubmed: 32203236
doi: 10.1038/s41430-020-0610-y
Gentile CL, Orr JS, Davy BM, Davy KP. Modest weight gain is associated with sympathetic neural activation in nonobese humans. Am J Physiol Regul Integr Comp Physiol. 2007;292:R1834–8.
pubmed: 17218435
doi: 10.1152/ajpregu.00876.2006
Flaa A, Aksnes TA, Kjeldsen SE, Eide I, Rostrup M. Increased sympathetic reactivity may predict insulin resistance: an 18-year follow-up study. Metabolism. 2008;57:1422–7.
pubmed: 18803948
doi: 10.1016/j.metabol.2008.05.012
Lambert E, Sari CI, Dawood T, Nguyen J, McGrane M, Eikelis N, et al. Sympathetic nervous system activity is associated with obesity-induced subclinical organ damage in young adults. Hypertension. 2010;56:351–8.
pubmed: 20625075
doi: 10.1161/HYPERTENSIONAHA.110.155663
Engström G, Hedblad B, Stavenow L, Lind P, Janzon L, Lindgärde F. Inflammation-sensitive plasma proteins are associated with future weight gain. Diabetes. 2003;52:2097–101.
pubmed: 12882928
doi: 10.2337/diabetes.52.8.2097
Doehner W, Erdmann E, Cairns R, Clark AL, Dormandy JA, Ferrannini E, et al. Inverse relation of body weight and weight change with mortality and morbidity in patients with type 2 diabetes and cardiovascular co-morbidity: an analysis of the PROactive study population. Int J Cardiol. 2012;162:20–26.
pubmed: 22037349
doi: 10.1016/j.ijcard.2011.09.039
Doehner W, Gerstein HC, Ried J, Jung H, Asbrand C, Hess S, et al. Obesity and weight loss are inversely related to mortality and cardiovascular outcome in prediabetes and type 2 diabetes: data from the ORIGIN trial. Eur Heart J. 2020;41:2668–77.
pubmed: 32402060
pmcid: 7377581
doi: 10.1093/eurheartj/ehaa293
Nam GE, Kim W, Han K, Lee CW, Kwon Y, Han B, et al. Body Weight Variability and the Risk of Cardiovascular Outcomes and Mortality in Patients With Type 2 Diabetes: A Nationwide Cohort Study. Diabetes Care. 2020;43:2234–41.
pubmed: 32641375
doi: 10.2337/dc19-2552
Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, et al. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement. Clin Nutr. 2015;34:335–40.
pubmed: 25799486
doi: 10.1016/j.clnu.2015.03.001
Makino K, Lee S, Bae S, Chiba I, Harada K, Katayama O, et al. Absolute Cardiovascular Disease Risk Assessed in Old Age Predicts Disability and Mortality: A Retrospective Cohort Study of Community-Dwelling Older Adults. J Am Heart Assoc. 2021;10:e022004.
pubmed: 34913358
pmcid: 9075253
doi: 10.1161/JAHA.121.022004
Costantino S, Paneni F, Cosentino F. Ageing, metabolism and cardiovascular disease. J Physiol. 2016;594:2061–73.
pubmed: 26391109
doi: 10.1113/JP270538
Katsoulis M, Stavola BD, Diaz-Ordaz K, Gomes M, Lai A, Lagiou P, et al. Weight Change and the Onset of Cardiovascular Diseases: Emulating Trials Using Electronic Health Records. Epidemiology. 2021;32:744–55.
pubmed: 34348396
pmcid: 8318567
doi: 10.1097/EDE.0000000000001393
Hernán MA, Taubman SL. Does obesity shorten life? The importance of well-defined interventions to answer causal questions. Int J Obes. 2008;32:S8–S14.
doi: 10.1038/ijo.2008.82