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Body mass index, abdominal fatness, and hypertension incidence: a dose-response meta-analysis of prospective studies

Journal of Human Hypertensionvolume 32pages321333 (2018) | Download Citation


Despite the established relationship of obesity to hypertension, the question as to whether there is a linear association between these two morbidities is unanswered. To quantitatively evaluate the relationship between obesity and hypertension, we carried out a dose–response meta-analysis of studies that looked at the relationship of different adiposity measures to hypertension. We searched PubMed, Embase, and Web of Science databases for articles published before 27 June 2017. A random-effects model was used to pool relative risks and 95% confidence intervals. Restricted cubic spline analysis was used to model the relationship. A total of 59 studies were included. Fifty-seven cohort studies with 125,071 incident cases among 830,685 participants were included in the analysis of body mass index and hypertension with the summary relative risk for per 5-unit increment in body mass index of 1.50 (95% confidence interval: 1.40–1.59). We found that the risk of hypertension in the body mass index analysis was greater in populations where the baseline body mass index was <25 kg/m2. The summary relative risk for a 10-cm increase in waist circumference was 1.25 (95% confidence interval: 1.19–1.32) and per 0.1-unit increase in waist-to-hip ratio was 1.27 (95% confidence interval: 1.18–1.37). This meta-analysis suggests that in normal range of obesity indexes, as lean as possible may be the best suggestion to prevent hypertension incidence.

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  1. These authors contributed equally: Wen Zhou, Yuanyuan Shi.


  1. Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, China

    • Wen Zhou
    • , Yuanyuan Shi
    • , Zhiguang Ping
    • , Chongjian Wang
    • , Xuejiao Liu
    • , Jie Lu
    • , Zhen-xing Mao
    • , Dongdong Zhang
    • , Zhongyan Tian
    • , Lulu Zhang
    •  & Linlin Li
  2. Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, 450001, China

    • Yu-qian Li
  3. Department of Endocrinology, Military Hospital of Henan Province, Zhengzhou, 18 Jinshui Road, Henan, 450003, China

    • Jingzhi Zhao
    •  & Lei Yin


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