Changes in the body mass index and blood pressure association across time: Evidence from multiple cross-sectional and cohort studies.
Changes in the body mass index and blood pressure association across time: Evidence from multiple cross-sectional and cohort studies.
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DOI：
10.1016/j.ypmed.2021.106825
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发表时间：
2021-12
影响因子：
5.1
通讯作者：
O'Neill D
中科院分区：
文献类型：
--
作者：
Bann D;Scholes S;Hardy R;O'Neill D
尽管体重指数(BMI)被认为是高血压的关键决定因素，但其重要性可能会随着时间和年龄的不同而不同。我们利用不同的数据来源来调查这种相关性的时间变化：23个独立的(新抽样的)重复横断面研究(≥25年(1994年-2018年；N=126742)；以及3个英国出生队列(出生于1946年、1958年和1970年；N=18657)。在HSE中，相关性在最近几年较弱，这一趋势在老年人中最为明显。在对性别、抗高血压治疗和教育进行调整后，≥55年间成年人体重指数每增加1公斤/平方米的平均收缩压差值在1994年为0.75毫米汞柱(95%可信区间：0.60-0.90)，2003年为0.66毫米汞柱(0.46-0.85)，2018年为0.53毫米汞柱(0.35-0.71)。在1958年和1970年的队列中，BMI和SBP的相关性相似，但在1946年的队列中较弱，可能是由于血压测量设备的差异。分位数回归分析表明，BMI和SBP之间存在着低于和高于高血压阈值的关联。体重指数和血压之间较弱的关联可能会部分抵消肥胖率上升对公众健康的影响。然而，尽管降压药的使用量大幅增加，但在所有年龄段，BMI仍与SBP呈正相关。我们的发现强调了解决非医疗因素的必要性，例如影响BMI和血压的人群饮食，以及使用多个数据集来获得对风险因素-结果关联随时间变化趋势的有力推断的效用。我们调查了1989年至2018年体重指数(BMI)和血压(BP)相关性的趋势。在对23项横断面研究的分析中，BMI和BP的相关性减弱，特别是在老年人中。来自3个出生队列的证据不一致，并可能因测量差异而产生偏差。体重指数和结果之间联系的减弱可能会部分抵消肥胖流行病的影响。结果突显了使用多个数据集来获得对时间趋势的可靠推断的效用。
Although body mass index (BMI) is considered a key determinant of high blood pressure, its importance may differ over time and by age group. We utilised separate data sources to investigate temporal changes in this association: 23 independent (newly sampled), repeated cross-sectional studies (Health Survey for England (HSE)) at ≥25 years (1994–2018; N = 126,742); and three British birth cohorts at 43–46 years (born 1946, 1958, and 1970; N = 18,657). In HSE, associations were weaker in more recent years, with this trend most pronounced amongst older adults. After adjustment for sex, anti-hypertensive treatment and education, the mean difference in systolic blood pressure (SBP) per 1 kg/m2 increase in BMI amongst adults ≥55 years was 0.75 mmHg (95%CI: 0.60–0.90) in 1994, 0.66 mmHg (0.46–0.85) in 2003, and 0.53 mmHg (0.35–0.71) in 2018. In the 1958 and 1970 cohorts, BMI and SBP associations were of similar magnitude yet weaker in the 1946 cohort, potentially due to differences in blood pressure measurement device. Quantile regression analyses suggested that associations between BMI and SBP were present both below and above the hypertension threshold. A weaker association between BMI and blood pressure may partly offset the public health impacts of increasing obesity prevalence. However, despite sizable increases in use of antihypertensive medication, BMI remains positively associated with SBP in all ages. Our findings highlight the need to tackle non-medical factors such as population diet which influence both BMI and blood pressure, and the utility of using multiple datasets to obtain robust inferences on trends in risk factor-outcome associations across time. We investigated trends in body mass index (BMI) and blood pressure (BP) associations from 1989 to 2018. In analysis of 23 cross-sectional studies, BMI and BP associations weakened, particularly in older adults. Evidence from 3 birth cohorts was inconsistent and potentially biased by measurement differences. Weakening links between BMI and outcomes may partly offset the impact of the obesity epidemic. Results highlight the utility of using multiple datasets to obtain robust inferences on trends across time.
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影响因子：
6.3
作者：
Chang, Kiara C-M;Vamos, Eszter P.;Millett, Christopher
通讯作者：
Millett, Christopher
DOI：
10.1001/jama.2017.3090
发表时间：
2017-04-11
期刊：
JAMA
影响因子：
--
作者：
Gottesman RF;Schneider AL;Zhou Y;Coresh J;Green E;Gupta N;Knopman DS;Mintz A;Rahmim A;Sharrett AR;Wagenknecht LE;Wong DF;Mosley TH
通讯作者：
Mosley TH
影响因子：
8
作者：
Ryu, Seungho;Frith, Emily;Loprinzi, Paul D.
通讯作者：
Loprinzi, Paul D.
影响因子：
48
作者：
Lane, Christopher A.;Barnes, Josephine;Schott, Jonathan M.
通讯作者：
Schott, Jonathan M.
影响因子：
3.6
作者：
Jackson, Andrew S.;Janssen, Ian;Blair, Steven N.
通讯作者：
Blair, Steven N.