A cohort study on body mass index and risk of all-cause mortality among hypertensive population / 中华流行病学杂志

ABSTRACT

Objective To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population.Methods All participants were selected from a prospective cohort study based on a rural population from Henan province,China.Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality.Restricted cubic spline models were used to detect the doseresponse relation.Results Among the 5 461 hypertensive patients,a total of 31 048.38 person-years follow-up was conducted.The median of follow-up time was 6 years,and 589 deaths occurred during the follow-up period.Compared to normal weight group (18.5 kg/m2＜BMI＜24.0 kg/m2) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (＜ 18.5 kg/m2,24-28 kg/m2,and ≥28 kg/m2) were 0.83 (95％CI0.37-1.87),0.81 (95％CI0.67-0.97),and 0.72 (95％CI0.56-0.91),respectively.The dose-response analysis showed a nonlinear,reverse "S" shaped relationship (non-linearity P＜0.001).Conclusion Overweight or obese might have a protective effect on all-cause mortality in hypertensive population,which supports the "obesity paradox" phenomenon.