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Trajectories of body mass index (BMI) and hypertension risk among middle-aged and elderly Chinese people

Journal of Human Hypertension volume 35, pages 537–545 (2021)Cite this article

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Abstract

This study aimed to identify heterogeneity in BMI trajectories and evaluate the impact of BMI trajectories on the risk of hypertension in middle-aged and elderly Chinese people. After data screening, 28, 706 residents’ e-health records from 2010 to 2018, including basic personal information, lifestyle and health, were finally included in this population-based longitudinal study. By latent class growth modeling, we identified 12 BMI trajectories: “underweight—increase I (A1)” and “underweight—increase II (A2)”; “normal weight—stable (B1)”, “normal weight—decrease (B2)”, “normal weight—increase I (B3)” and “normal weight—increase II (B4)”; “overweight—stable (C1)”, “overweight—decrease (C2)” and “overweight—increase (C3)”; and “obese—stable I (D1)”, “obese—decrease (D2)” and “obese—stable II (D3)”. By Cox proportional hazards models, we found that the risk of hypertension in the BMI stable group was lower than that in the BMI increasing trajectory group and higher than that in the BMI decreasing group. For the underweight and normal weight groups, the risk of hypertension was related not only to the magnitude of BMI growth, but also to the rate of growth. For overweight and obesity groups, the risk of hypertension was higher in the high-level stable BMI group than in the low-level stable BMI group. Therefore, for underweight and normal weight people, weight growth and growth rate should be controlled; for overweight and obese people, health education or targeted weight loss exercise should be taken to reduce weight as much as possible to prevent hypertension.

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Fig. 1
Fig. 2: Trajectories of BMI groups from 2010 to 2018.

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Code availability

The core code example of SAS to fit LCGM in this study are as follows:

PROC TRAJ DATA = OPOPOSITN OUTPLOT = OP OUTSTAT = OS OUT = OUTEST = OE

ITDETAIL; ID ID; VAR BMI2010-BMI2018; INDEP T2011-T2018;

MODEL CNORM; MAX 45; NGROUPS 3; ORDER 3 3 3;

RUN;

For more information about LCGM, please refer to the website: http://www.andrew.cmu.edu/user/bjones/.

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Acknowledgements

The authors thank all of the individuals, investigators, and administrators for their support and help during the research. We are also grateful to Yujing Zhang for their insightful comments that greatly improved the paper.

Funding

This research was funded by the National Key Research and Development Program of China (2017YFC1307705 and 2016YFC0106907), the Science and Technology Development Program of Henan (201403007), the Science and Technology Development Program of Zhengzhou (141PPTGG441), and the Key Science and Technology Research of Henan Department of Education (14A330009).

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Author notes

  1. These authors contributed equally: Bingxin Guo, Zhan Shi

Authors and Affiliations

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

    Bingxin Guo, Wenli Zhang, Hao Zhao, Kun He, Xueqi Hu & Songhe Shi

  2. Department of Pharmacy, People’s Hospital of Zhengzhou, Huanghe Road 33, Zhengzhou, 450003, Henan, China

    Zhan Shi

  3. Department of Pharmacy, Fuwai Central China Cardiovascular Hospital, Fuwai Avenue 1, Zhengzhou, 450000, Henan, China

    Yuan Gan

  4. Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China

    Qingfeng Tian

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Guo, B., Shi, Z., Zhang, W. et al. Trajectories of body mass index (BMI) and hypertension risk among middle-aged and elderly Chinese people. J Hum Hypertens 35, 537–545 (2021). https://doi.org/10.1038/s41371-020-0368-7

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