Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

The association between body mass index and incident hypertension in rural women in China

European Journal of Clinical Nutrition volume 64, pages 769–775 (2010)Cite this article

Subjects

Abstract

Background/Objectives:

To evaluate the association between body mass index (BMI) and incident hypertension in a cohort of rural women in the Chinese population.

Subjects/Methods:

A population-based sample of 11 468 rural Chinese women aged ⩾35 years and free from hypertension at baseline were followed-up from 2004–2006 to 2008. We calculated BMI from measured weight and height. Incident hypertension was defined as systolic blood pressure (BP) ⩾140 mm Hg, diastolic BP⩾90 mm Hg or current use of antihypertensive medications.

Results:

During a median follow-up of 28 months, 2666 participants developed hypertension. Higher baseline BMI, even within the ‘normal’ range, was consistently associated with an increased risk of hypertension. Compared with participants in the lowest BMI quintile (18.5–21.1 kg/m2), the multivariable-adjusted relative risks (95% confidence interval) of developing hypertension for women with a BMI of 21.2 to 22.4, 22.5 to 23.7, 23.8 to 25.4 and ⩾25.4 kg/m2 were 1.200 (1.058–1.361), 1.250 (1.100–1.419), 1.466 (1.291–1.666) and 1.785 (1.584–2.012), respectively (P for trend, <0.001). Further adjustment for baseline BP did not substantially alter these results. We found similar associations using other BMI categories and after excluding women with smoking history at baseline. The pattern of association also existed among old women (age ⩾55 years).

Conclusions:

In this large cohort, we found a strong gradient association between higher BMI and increased risk of hypertension, even among older women within the normal BMI range. Clinicians should emphasize the importance of weight management for the primary prevention of hypertension in rural women in the Chinese population.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  • Dyer AR, Elliott P (1989). The INTERSALT study: relations of body mass index to blood pressure. INTERSALT Co-operative Research Group. J Hum Hypertens 3, 299–308.

    CAS  PubMed  Google Scholar 

  • Foucan L, Hanley J, Deloumeaux J, Suissa S (2002). Body mass index (BMI) and waist circumference (WC) as screening tools for cardiovascular risk factors in Guadeloupean women. J Clin Epidemiol 55, 990–996.

    Article  Google Scholar 

  • Gelber RP, Gaziano JM, Manson JE, Buring JE, Sesso HD (2007). A prospective study of body mass index and the risk of developing hypertension in men. Am J Hypertens 20, 370–377.

    Article  Google Scholar 

  • He J, Whelton PK, Appel LJ, Charleston J, Klag MJ (2000). Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Hypertension 35, 544–549.

    Article  CAS  Google Scholar 

  • Hsueh WA, Buchanan TA (1994). Obesity and hypertension. Endocrinol Metab Clin North Am 23, 405–427.

    Article  CAS  Google Scholar 

  • Hu FB, Wang B, Chen C, Jin Y, Yang J, Stampfer MJ et al. (2000). Body mass index and cardiovascular risk factors in a rural Chinese population. Am J Epidemiol 151, 88–97.

    Article  CAS  Google Scholar 

  • Hu G, Barengo NC, Tuomilehto J, Lakka TA, Nissinen A, Jousilahti P (2004). Relationship of physical activity and body mass index to the risk of hypertension: a prospective study in Finland. Hypertension 43, 25–30.

    Article  CAS  Google Scholar 

  • Huang Z, Willett WC, Manson JE, Rosner B, Stampfer MJ, Speizer FE et al. (1998). Body weight, weight change, and risk for hypertension in women. Ann Intern Med 128, 81–88.

    Article  CAS  Google Scholar 

  • Ikeda T, Gomi T, Hirawa N, Sakurai J, Yoshikawa N (1996). Improvement of insulin sensitivity contributes to blood pressure reduction after weight loss in hypertensive subjects with obesity. Hypertension 27, 1180–1186.

    Article  CAS  Google Scholar 

  • Jousilahti P, Tuomilehto J, Vartiainen E, Valle T, Nissinen A (1995). Body mass index, blood pressure, diabetes and the risk of anti-hypertensive drug treatment: 12-year follow-up of middle-aged people in eastern Finland. J Hum Hypertens 9, 847–854.

    CAS  PubMed  Google Scholar 

  • Kolanowski J (1999). Obesity and hypertension: from pathophysiology to treatment. Int J Obes Relat Metab Disord 23 (Suppl 1), 42–46.

    Article  Google Scholar 

  • Liu L (2007). Cardiovascular diseases in China. Biochem Cell Biol 85, 157–163.

    Article  Google Scholar 

  • National Institute on Alcohol Abuse and Alcoholism (2000). Health risks and benefits of alcohol consumption. Tenth Special Report to the US Congress on Alcohol and Health 1, 5–11.

    Google Scholar 

  • Popkin BM (2006). Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr 84, 289–298.

    Article  CAS  Google Scholar 

  • Popkin BM, Kim S, Rusev ER, Du S, Zizza C (2006). Measuring the full economic costs of diet, physical activity and obesity-related chronic diseases. Obes Rev 7, 271–293.

    Article  CAS  Google Scholar 

  • Shuger SL, Sui X, Church TS, Meriwether RA, Blair SN (2008). Body mass index as a predictor of hypertension incidence among initially healthy normotensive women. Am J Hypertens 21, 613–639.

    Article  Google Scholar 

  • Stevens J, Truesdale KP, Katz EG, Cai J (2008). Impact of body mass index on incident hypertension and diabetes in Chinese Asians, American Whites, and American Blacks: the People's Republic of China Study and the Atherosclerosis Risk in Communities Study. Am J Epidemiol 167, 1365–1374.

    Article  Google Scholar 

  • Staessen JA, Celis H, Fagard R (1998). The epidemiology of the association between hypertension and menopause. J Hum Hypertens 12, 587–592.

    Article  CAS  Google Scholar 

  • Stevens VJ, Obarzanek E, Cook NR, Lee IM, Appel LJ, Smith West D et al. (2001). Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Ann Intern Med 134, 1–11.

    Article  CAS  Google Scholar 

  • Sun Z, Zheng L, Wei Y, Li J, Zhang X, Zhang X et al. (2007). The prevalence of prehypertension and hypertension among rural adults in Liaoning province of China. Clin Cardiol 30, 183–187.

    Article  Google Scholar 

  • Tian HG, Hu G, Dong QN, Yang XL, Nan Y, Pietinen P et al. (1996). Dietary sodium and potassium, socioeconomic status and blood pressure in a Chinese population. Appetite 26, 235–246.

    Article  CAS  Google Scholar 

  • Trials of Hypertension Prevention Collaborative Research Group (1997). Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The Trials of Hypertension Prevention, phase II. Arch Intern Med 157, 657–667.

    Article  Google Scholar 

  • Tuck ML, Sowers J, Dornfeld L, Kledzik G, Maxwell M (1981). The effect of weight reduction on blood pressure, plasma renin activity, and plasma aldosterone levels in obese patients. N Engl J Med 304, 930–933.

    Article  CAS  Google Scholar 

  • WHO (2003). The World Health Report 2002. WHO: Geneva.

  • Wu Y (2006). Overweight and obesity in China. BMJ 333, 362–363.

    Article  Google Scholar 

  • Wu Y, Huxley R, Li L, Anna V, Xie G, Yao C et al. (2008). China NNHS Steering Committee; China NNHS Working Group. Prevalence, awareness, treatment, and control of hypertension in China: data from the China National Nutrition and Health Survey 2002. Circulation 118, 2679–2686.

    Article  Google Scholar 

Download references

Acknowledgements

This research was supported by grants from the key technology Research and Development program of Liaoning Province (2003225003).

Author information

Authors and Affiliations

  1. Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China

    L Zheng, Z Sun, X Zhang & C Xu

  2. Department of General Surgery, Digestive Medical Center, First Affiliated Hospital of Tsinghua University, Beijing, People's Republic of China

    Z Zhang

  3. Heart, Lung and Blood Vessel Center, Tongji University, Shanghai, People's Republic of China

    J Li & D Hu

  4. Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China

    Y Sun

Authors
  1. L Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Z Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Z Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. X Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Y Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Y Sun.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zheng, L., Zhang, Z., Sun, Z. et al. The association between body mass index and incident hypertension in rural women in China. Eur J Clin Nutr 64, 769–775 (2010). https://doi.org/10.1038/ejcn.2010.97

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2010.97

Keywords

This article is cited by

Search

Advanced search

Quick links