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高血压和肥胖

Hypertension and Obesity in China
Professors  Chen Chunming  &  Zhao Wenhua
 (On behalf of the Working Group on Obesity in China, ILSI Focal Point in China), Chinese Center for Disease Control and Prevention, Beijing China
Part I:  Hypertension risk at BMI  and
waist circumference (WC) levels

International Life Science Institute Focal Point in China (ILSI FP-China) established a Working Group on Obesity in China (WGOC) in 2000. WGOC organized a meta analysis on the data from 13 big scale cross-sectional survey since 1990, under a protocol for analysis data collected among 239,972 adults aged 20-70 were included.
Data source and analysis
 Analysis on disease risks factors, such as high blood pressure, diabetes including fast blood glucose (FBG), serum cholesterol, HDL-C, triglycerides (TG), in relation to BMI and waist circumference (WC) was carried out. Meta analysis of cohort studies covered 4 data sets with 76,227 adult subjects was done, the end points are total mortality, mortality of coronary heart disease, stroke and cancer, as well as incidences of coronary heart disease events and stroke events. Part of the results is presented here.
   The results on the prevalence of hypertension, and clustering of risk factors (high blood pressure, diabetes including fast blood glucose (FBG), serum cholesterol, HDL, triglycerides ) and BMI or waist circumference (WC) was presented as follows.
BMI and high blood pressure
Male
Male
Female
The prevalence of hypertension increased with increasing levels of BMI.

WC and high blood pressure
Male
Female
The prevalence of hypertension increased with increasing levels of WC
BMI and risk factor clustering
Male
Female
The prevalence of  clustering of risk factors increased with increasing levels of BMI.
WC and risk factor clustering
Male
Female
The prevalence of  clustering of risk factors increased with increasing levels of WC.
     Population attributable risk percent (%) of hypertension at BMI levels

                           Male                     Female
                            OR*        PARP      OR        PARP
BMI ≥24          3.69          45.9         2.76        38.4

BMI ≥28          3.17          11.5         2.61        12.7

* Age adjusted
     Population attributable risk %
of hypertension beyond WC cutoffs
                             
                                               OR*         PARP

Men WC≥85cm                     3.44           41.3

Women WC≥80cm                3.30          42.8

* Age adjusted
Part II:  Correlation analysis of WC、
               BMI and blood pressure

Data source and analysis

 A study was conducted in Anhui and Henan provinces in 1996 by Chen Junshi and Zhao Wenhua.
 Totally 11,815 rural residents aged 40-79 were surveyed and information included  blood pressure, high, weight and waist circumference, diet and blood sample were collected.

   The relationship between  WC、BMI  and blood pressure was analyzed.
 

Correlation analysis of WC、BMI and blood pressure (male)
Correlation analysis of WC、BMI and blood pressure (Female)
Prevalence(%) of hypertension by BMI group (male)
*
BMI
%HP
BMI、WC and Prevalence of Hypertension
Prevalence(%) of hypertension by BMI group (Female)
BMI
%HP
*
Prevalence(%) of hypertension by WC group (male)
*
Prevalence(%) of hypertension by WC group (Female)
*
Combination of BMI and WC in relation to hypertension prevalence
BMI
Combination of BMI and WC in relation
to hypertension prevalence (Male)
Combination of BMI and WC in relation to hypertension prevalence (Female)
BMI
When WC≥75cm, prevalence of hypertension increased significantly(P<0.05).
 Hypertension prevalence % at various WC levels with BMI≥24(male)
*
Hypertension prevalence % at various WC levels with BMI≥24(female)
*
At BMI ≥24, WC ≥80 (male) WC ≥75 (female), prevalence or hypertension dramatically increased (p<0.05 for all groups)

  
Part III: Summary and Conclusion

    Data indicated application of Combination of BMI and WC will be the best predictor for hypertension risk, recommendation was made to set overweight cutoff at BMI≥ 24; WC≤85 for men and ≤ 80cm  for women as normal.

Applying the classification, overweight (BMI≥24) prevalence is 30-40%, if  BMI could be  controlled under 24, 38-45% hypertension of this population, 33-37% of diabetes,  45-50% risk factor clustering may be prevented.


If the 8-12% obesity population (BMI ≥28) could be  treated, 15-17% risk factor clustering could be prevented. 


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