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Article: Does body mass index impact on the relationship between systolic blood pressure and cardiovascular disease?: meta-analysis of 419 488 individuals from the Asia Pacific cohort studies collaboration

TitleDoes body mass index impact on the relationship between systolic blood pressure and cardiovascular disease?: meta-analysis of 419 488 individuals from the Asia Pacific cohort studies collaboration
Authors
Issue Date2012
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://stroke.ahajournals.org
Citation
Stroke, 2012, v. 43 n. 6, p. 1478-1483 How to Cite?
AbstractBACKGROUND AND PURPOSE: Elevated blood pressure and excess body mass index (BMI) are established risk factors for cardiovascular disease (CVD) but controversy exists as to whether, and how, they interact. METHODS: The interactions between systolic blood pressure and BMI on coronary heart disease, ischemic and hemorrhagic stroke and CVD were examined using data from 419 448 participants (>/= 30 years) in the Asia-Pacific region. BMI was categorized into 5 groups, using standard criteria, and systolic blood pressure was analyzed both as a categorical and continuous variable. Cox proportional hazard models, stratified by sex and study, were used to estimate hazard ratios, adjusting for age and smoking and the interaction was assessed by likelihood ratio tests. RESULTS: During 2.6 million person-years of follow-up, there were 10 877 CVD events. Risks of CVD and subtypes increased monotonically with increasing systolic blood pressure in all BMI subgroups. There was some evidence of a decreasing hazard ratio, per additional 10 mm Hg systolic blood pressure, with increasing BMI, but the differences, although significant, are unlikely to be of clinical relevance. The hazard ratio for CVD was 1.34 (95% CI, 1.32-1.36) overall with individual hazard ratios ranging between 1.28 and 1.36 across all BMI groups. For coronary heart disease, ischemic stroke, and hemorrhagic stroke, the overall hazard ratios per 10 mm Hg systolic blood pressure were 1.24, 1.46, and 1.65, respectively. CONCLUSIONS: Increased blood pressure is an important determinant of CVD risk irrespective of BMI. Although its effect tends to be weaker in people with relatively high BMI, the difference is not sufficiently great to warrant alterations to existing guidelines.
Persistent Identifierhttp://hdl.handle.net/10722/149172
ISSN
2015 Impact Factor: 5.787
2015 SCImago Journal Rankings: 3.671
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTsukinoki, Ren_US
dc.contributor.authorMurakami, Yen_US
dc.contributor.authorHuxley, Ren_US
dc.contributor.authorOhkubo, Ten_US
dc.contributor.authorFang, Xen_US
dc.contributor.authorSuh, Ien_US
dc.contributor.authorUeshima, Hen_US
dc.contributor.authorLam, THen_US
dc.contributor.authorWoodward, Men_US
dc.contributor.authorAsia Pacific Cohort Studies Collaboration-
dc.date.accessioned2012-06-22T06:27:45Z-
dc.date.available2012-06-22T06:27:45Z-
dc.date.issued2012en_US
dc.identifier.citationStroke, 2012, v. 43 n. 6, p. 1478-1483en_US
dc.identifier.issn0039-2499en_US
dc.identifier.urihttp://hdl.handle.net/10722/149172-
dc.description.abstractBACKGROUND AND PURPOSE: Elevated blood pressure and excess body mass index (BMI) are established risk factors for cardiovascular disease (CVD) but controversy exists as to whether, and how, they interact. METHODS: The interactions between systolic blood pressure and BMI on coronary heart disease, ischemic and hemorrhagic stroke and CVD were examined using data from 419 448 participants (>/= 30 years) in the Asia-Pacific region. BMI was categorized into 5 groups, using standard criteria, and systolic blood pressure was analyzed both as a categorical and continuous variable. Cox proportional hazard models, stratified by sex and study, were used to estimate hazard ratios, adjusting for age and smoking and the interaction was assessed by likelihood ratio tests. RESULTS: During 2.6 million person-years of follow-up, there were 10 877 CVD events. Risks of CVD and subtypes increased monotonically with increasing systolic blood pressure in all BMI subgroups. There was some evidence of a decreasing hazard ratio, per additional 10 mm Hg systolic blood pressure, with increasing BMI, but the differences, although significant, are unlikely to be of clinical relevance. The hazard ratio for CVD was 1.34 (95% CI, 1.32-1.36) overall with individual hazard ratios ranging between 1.28 and 1.36 across all BMI groups. For coronary heart disease, ischemic stroke, and hemorrhagic stroke, the overall hazard ratios per 10 mm Hg systolic blood pressure were 1.24, 1.46, and 1.65, respectively. CONCLUSIONS: Increased blood pressure is an important determinant of CVD risk irrespective of BMI. Although its effect tends to be weaker in people with relatively high BMI, the difference is not sufficiently great to warrant alterations to existing guidelines.-
dc.languageengen_US
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://stroke.ahajournals.orgen_US
dc.relation.ispartofStrokeen_US
dc.rightsThis is a non-final version of an article published in final form in (Stroke, 2012, v. 43 n. 6, p. 1478-1483)en_US
dc.subject.meshAsia, Southeastern - epidemiology-
dc.subject.meshBlood Pressure-
dc.subject.meshBody Mass Index-
dc.subject.meshCardiovascular Diseases - epidemiology - physiopathology-
dc.subject.meshFollow-Up Studies-
dc.titleDoes body mass index impact on the relationship between systolic blood pressure and cardiovascular disease?: meta-analysis of 419 488 individuals from the Asia Pacific cohort studies collaborationen_US
dc.typeArticleen_US
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0039-2499&volume=43&issue=6&spage=1478&epage=1483&date=2012&atitle=Does+body+mass+index+impact+on+the+relationship+between+systolic+blood+pressure+and+cardiovascular+disease?:+Meta-analysis+of+419+488+individuals+from+the+Asia+Pacific+cohort+studies+collaborationen_US
dc.identifier.emailLam, TH: hrmrlth@hkucc.hku.hken_US
dc.identifier.emailWoodward, M: markw@georgeinstitute.org.au-
dc.identifier.authorityLam, TH=rp00326en_US
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1161/STROKEAHA.112.650317-
dc.identifier.pmid22426316-
dc.identifier.scopuseid_2-s2.0-84861588247-
dc.identifier.hkuros200192en_US
dc.identifier.volume43en_US
dc.identifier.issue6en_US
dc.identifier.spage1478en_US
dc.identifier.epage1483en_US
dc.identifier.isiWOS:000304523800013-
dc.publisher.placeUnited States-

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