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Epidemiology and Population Health

Body weight, weight change and the risk of cardiovascular disease in patients with hypertension: a primary-care cohort study

International Journal of Obesity volume 47, pages 848–854 (2023)Cite this article

Subjects

Abstract

Background/objectives

Obesity and cardiovascular disease (CVD) often co-occur. However, the effects of excessive body weight and weight change on CVD in patients with hypertension are not clearly established. We examined the associations of BMI, weight change and the risk of CVD in patients with hypertension.

Subjects/methods

Our Data were drawn from the medical records of primary-care institutions in China. A total of 24,750 patients with valid weight measurements attending primary healthcare centers were included. Body weight were grouped in BMI categories of underweight ( < 18.5 kg/m2), healthy weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2) and obesity ( ≥ 25.0 kg/m2). Weight change over 12 months was divided into: gain >4%, gain 1–4%, stable (−1 to 1%), loss 1–4%, and loss ≥4%. Cox regression analyses were used to estimate hazard ratio (HR) and 95% confidence interval (95% CI) between BMI, weight change and the risk of CVD.

Results

After multivariable adjustment, patients with obesity were related to higher risks of CVD (HR = 1.48, 95% CI: 1.19–1.85). Higher risks were seen in participants with loss ≥4% and gain >4% of body weight compared to stable weight (loss ≥4%: HR = 1.33, 95% CI: 1.04–1.70; gain >4%: HR = 1.36, 95% CI: 1.04–1.77).

Conclusion

Obesity and weight change of loss ≥4% and gain >4% were related to higher risks of CVD. Close monitoring and appropriate interventions aimed at achieving an optimal weight are needed to prevent adverse cardiovascular outcomes for patients with hypertension.

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Fig. 1
Fig. 2: Association between baseline BMI and weight change with risk of cardiovascular disease of patients with hypertension.
Fig. 3: Subgroup analyses of association between the baseline BMI and weight change categories with cardiovascular disease stratified by baseline BMI, age, and sex.

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Data availability

The datasets and computer code analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We sincerely thank all the general practitioners who kindly devoted their time to the study.

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Author notes

  1. These authors contributed equally: Yue Dong, Yanhong Gong.

Authors and Affiliations

  1. School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, PR China

    Yue Dong, Yanhong Gong, Rongrong An, Na Sun, Zhenyuan Chen & Xiaoxv Yin

  2. Department of Community Health Management, Baoan Central Hospital of Shenzhen, Shenzhen, 518000, PR China

    Yanping Han, Hanbing Yu, Xiaozhou Zeng & Zimei Chen

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Contributions

All authors were involved in study conception and design. XY, YD and YG created the concept and design of the manuscript. YD, YH, HY and ZC conducted the data analysis and drafted the manuscript. XZ, RA and ZC contributed to the interpretation of results and revised the manuscript. NS contributed to the acquisition of data. XY is the guarantor of this article.

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Correspondence to Xiaoxv Yin.

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Dong, Y., Gong, Y., Han, Y. et al. Body weight, weight change and the risk of cardiovascular disease in patients with hypertension: a primary-care cohort study. Int J Obes 47, 848–854 (2023). https://doi.org/10.1038/s41366-023-01335-z

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