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Association of 6-year waist-circumference change with progression from prehypertension to hypertension: the Rural Chinese Cohort Study

Journal of Human Hypertension volume 35, pages 215–225 (2021)Cite this article

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Abstract

Whether dynamic change in waist circumference is associated with progression from prehypertension to hypertension is not well understood. We explored this issue. A total of 4221 prehypertensive adults ≥18 years were enrolled during 2007–2008 and followed up during 2013–2014. Participants were classified by percentage waist-circumference change at follow-up: ≤−2.5, −2.5 to ≤2.5, 2.5 to ≤5.0, and >5.0%. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with logistic regression models, with stable waist-circumference change (−2.5 to 2.5%) as the reference. During the 6 years of follow-up, 1464 prehypertensive patients (851 women) showed progression to hypertension, with an incidence rate of 32.7% for men and 36.3% for women. As compared with stable waist circumference, a waist-circumference gain > 5.0% was associated with increased hypertension risk: adjusted ORs (95% CI) were 1.08 (1.01–1.14) for men and 1.09 (1.04–1.15) for women. The risk also decreased significantly for men with ≥2.5% waist-circumference loss (OR = 0.94, 95% CI 0.88–1.00). We found a linear association between percentage waist-circumference gain and risk of progression from prehypertension to hypertension for both sexes by restricted cubic splines (pnonlinearity = 0.772 for men and 0.779 for women). For each 10% gain in waist circumference, the risk increased by 8% for men and 5% for women. The association remained significant for both sexes in a subgroup analysis by abdominal obesity at baseline. The long-term gain in waist circumference significantly increased the risk of progression from prehypertension to hypertension for both sexes in a rural Chinese population, regardless of abdominal obesity status at baseline.

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Fig. 1: Dose–response association between percentage waist-circumference change and risk of progression from prehypertension to hypertension.
Fig. 2: Dose–response associations between percentage waist-circumference change and risk of progression from prehypertension to hypertension by abdominal obesity status at baseline.

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Acknowledgements

We thank Mrs Laura Smales for proofreading of the paper.

Funding

This work was supported by the National Natural Science Foundation of China [grant nos. 81373074, 81402752, and 81673260]; the Natural Science Foundation of Guangdong Province [grant no. 2017A030313452]; the Medical Research Foundation of Guangdong Province [grant no. A2017181]; and the Science and Technology Development Foundation of Shenzhen [grant nos. CYJ20140418091413562, JCYJ20160307155707264, JCYJ20170412110537191, and JCYJ20170302143855721]. The funding body has no role in the design of the study, collection and analysis of data, or decision to publish.

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Authors and Affiliations

  1. School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China

    Pei Qin, Qionggui Zhou, Dechen Liu, Xiaoyan Wu, Yang Li, Dongsheng Hu & Ming Zhang

  2. Department of Mental Health, Bao’an Chronic Diseases Prevent and Cure Hospital, Shenzhen, Guangdong, People’s Republic of China

    Qing Chen, Dechen Liu, Gang Tian, Ranran Qie, Minghui Han, Shengbing Huang & Dongsheng Hu

  3. Key Lab of Epidemiology, Department of Infectious Disease Control and Prevention, Shenzhen Guangming District Center for Disease Control and Prevention, Shenzhen, Guangdong, People’s Republic of China

    Tieqiang Wang, Xiaoliang Chen, Chunmei Guo, Dechen Liu & Dongsheng Hu

  4. Department of Epidemiology and Health Statistics, School of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China

    Yang Zhao, Quanman Li, Dechen Liu, Leilei Liu & Dongsheng Hu

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  1. Pei Qin
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Contributions

PQ, DH, and MZ conceived, designed, and performed the work. PQ performed data analysis and drafted the paper. QC, TW, XC, YZ, QZ, QL, CG, DL, GT, XW, RQ, MH, SH, LL, and YL acquired the data and revised the paper. MZ has had full access to the data in the study and final responsibility for the decision to submit for publication. All authors approved the final paper and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Ming Zhang.

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Qin, P., Chen, Q., Wang, T. et al. Association of 6-year waist-circumference change with progression from prehypertension to hypertension: the Rural Chinese Cohort Study. J Hum Hypertens 35, 215–225 (2021). https://doi.org/10.1038/s41371-020-0322-8

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