Research Paper Volume 13, Issue 5 pp 6866—6877
Association between body mass index and risk of cardiovascular disease-specific mortality among adults with hypertension in Shanghai, China
- 1 Department of Biostatistics, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- 2 Shanghai Minhang Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- 3 Minhang District Branch of School of Public Health, Fudan University, Shanghai, People’s Republic of China
- 4 Key Lab of Health Technology Assessment, National Health Commission of the People’s Republic of China, Fudan University, Shanghai, People’s Republic of China
Received: August 6, 2020 Accepted: December 25, 2020 Published: February 17, 2021https://doi.org/10.18632/aging.202543
How to Cite
Copyright: © 2021 Hu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The aim of our study was to examine the association between body mass index (BMI) and the risk of cardiovascular disease (CVD)-specific mortality among Chinese adults with hypertension by sex. This study included 212,394 adult hypertensive patients aged 20–85 years registered in the records of Minhang District during 2007–2018. Cox proportional hazards regression was performed to evaluate the association between BMI and CVD-specific mortality among Chinese adults with hypertension. There were 14,029 deaths over an average of 8.24 years (range, 0.19–11.96 years). The multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) across BMI categories (< 18.5 kg/m2, 18.5–24.9 kg/m2 [reference group], 25.0–29.9 kg/m2, and ≥ 30 kg/m2) for CVD-specific mortality were 1.37 (1.22–1.53), 1.00 (reference), 0.95 (0.90–1.01), and 1.21 (1.04–1.40) in males, and 1.44 (1.31–1.59), 1.00 (reference), 0.96 (0.91–1.01), and 1.04 (0.92–1.17) in females. A U-shaped relationship was observed between BMI and CVD-specific mortality (overall association P< 0.001; non-linearity P< 0.001). This association was attenuated in old age. This study revealed a U-shaped relationship between BMI and CVD-specific mortality among hypertensive men and women. In older people, overweight and obesity are potential factors that reduce the risk of CVD death.
BMI: body mass index; CVD: cardiovascular disease; ICD: international classification of diseases; RCS: restrictive cubic spline; HRs: hazard ratios.