Abstract
This study aimed to assess the prevalence and related factors of obesity-related hypertension among adults aged 40 to 79 years in Southwest China. From September 2013 to March 2014, a multi-stage, stratified sampling method was conducted on 10,589 people aged 40 to 79 years and living in Chengdu and Chongqing investigated by using a questionnaire and performing physical and biochemical measurements. The prevalence of obesity-related hypertension and hypertension overall (systolic ≥130 mmHg and/or diastolic ≥80 mmHg or treated hypertension) was 22.8% and 57.4%, respectively, among all participants. For obesity-related hypertension, the prevalence was higher in women than in men (24.7% versus 19.4%, p < 0.001). For people in the age ranges of 40–49, 50–59, 60–69, and ≥70, the prevalence of obesity-related hypertension were 11.8%, 22.6%, 30.7%, and 36.6%, respectively. Participants with obesity-related hypertension as opposed to those with non-obesity-related hypertension had a higher prevalence of hypertriglyceridemia, high low-density lipoprotein cholesterolemia, diabetes, and hyperuricemia (all p < 0.05). Multivariate logistic regression analysis showed that age, female gender, current smoking, hypertriglyceridemia, diabetes and family history of hypertension were all positively correlated with obesity-related hypertension, whereas higher education level and having spouse were negatively correlated with obesity-related hypertension. The prevalence of obesity-related hypertension was high among adults aged 40 to 79 years in Southwest China. Cardiometabolic abnormalities among participants with obesity-related hypertension were more serious and frequently present than in those with non-obesity-related hypertension. Aggressive and holistic strategies aiming at the prevention and treatment of obesity-related hypertension are needed.
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Introduction
Hypertension is a major risk factor that leads to myocardial infarction, stroke, renal failure, and death1,2. Obesity raises the risk of morbidity from hypertension, dyslipidemia, diabetes, coronary heart disease (CHD), stroke and heart failure3,4,5,6. Hypertension and obesity are both associated with increased risks of all-cause and cardiovascular mortality7,8,9, and they often occur together10. Socioeconomic and demographic transitions occurring in many develo** countries have contributed to the burden of hypertension and obesity2,11, and the transition of morbidity from communicable diseases to non-communicable diseases12,13. With the rapid industrialization and urbanization seen in recent decades, the prevalence of hypertension and obesity has increased significantly in China, with the prevalence of obesity increased from 4.0% in 2002 to 10.7% in 200954,55,56, and a higher UA level has been associated with an increased risk of hypertension57,58. In addition, we found that the prevalence of high LDL-C was higher in obesity-related hypertensive patients. Compared to the non-obesity-related hypertensive patients, regular screenings for cardiovascular metabolic risk factors in obesity-related hypertensive patients should be advocated.
The strengths of this study include a large number of community-dwelling participants included in this survey and a detailed report of hypertension and obesity-related hypertension based on the 2017 ACC Guidelines in Southwest China. Our study has several limitations. First, this study was a cross-sectional study, meaning that the findings cannot be used to establish a conclusive cause-and-effect relationship between risk factors and obesity-related hypertension. Second, the participants were recruited from Southwest China, such that the conclusions cannot represent the situation in other regions of China. Third, we did not perform detailed body composition analysis due to constraints of budgets.
Conclusions
The prevalence of obesity-related hypertension was high in people aged 40 to 79 years in Southwest China. Its prevalence was higher in women than in men and increased with age. Additionally, patients with obesity-related hypertension had a higher prevalence of DM, hypertriglyceridemia, high low-density lipoprotein cholesterolemia and hyperuricemia than non-obesity-related hypertensive patients. Aggressive strategies aiming at the prevention and treatment of obesity-related hypertension are needed.
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Acknowledgements
This research was supported by the Szechwan Province Science and Technology Agency Fund Project (2009FZ 0027), Chengdu, China and Population and health project of Chengdu Municipal Science and Technology Bureau (10YTYB272SF-182), Chengdu, China.
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X.B.H., T.D.W. put forward key ideas, objectives and goals. F.X., W.W.T. and L.S.H. participated in the design of this study and performed the statistical analysis. X.B.H., J.X.L., Y.L., Y.J.Y., T.S.H. and R.H. participated in the data collection and checked the data. Y.Z., L.S.H., X.L., X.B.H., T.D.W. and R.H.X. wrote and edited the manuscript.
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Zhang, Y., Hou, LS., Tang, WW. et al. High prevalence of obesity-related hypertension among adults aged 40 to 79 years in Southwest China. Sci Rep 9, 15838 (2019). https://doi.org/10.1038/s41598-019-52132-6
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DOI: https://doi.org/10.1038/s41598-019-52132-6
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