Association of Body Mass Index with Cause Specific Deaths in Chinese Elderly Hypertensive Patients: Minhang Community Study

Abstract

BackgroundMost studies have suggested that elevated body mass index (BMI) was associated with the risk of death from all cause and from specific causes. However, there was little evidence illustrating the effect of BMI on the mortality in elderly hypertensive patients in Chinese population.MethodsThe information of 10,957 hypertensive patients at baseline not less than 60 years were from Xinzhuang, a town in Minhang district of Shanghai, was extracted from the Electronic Health Record (EHR) system. All study participants were divided into eight categories of baseline BMI (with cut-points at 18, 20, 22, 24, 26, 28 and 30 kg/m2). Relative hazard ratio of death from all cause, cardiovascular and non-cardiovascular cause by baseline BMI groups were calculated, standardized for sex, age, smoking, drinking, physical activity, systolic blood pressure, history of cardiovascular disorders, serum lipid disturbance, diabetes mellitus and antihypertensive drug treatment.ResultsDuring follow up (median: 3.7 years), 561 deaths occurred. Underweight (BMI<18 kg/m2) was associated with significantly increased mortality from all cause mortality (OR: 2.00; 95% CI: 1.43–2.79) and non cardiovascular mortality (OR: 2.76; 95% CI: 1.87–4.07), but not with cardiovascular mortality. For the cause specific analysis, the underweight was associated significantly with neoplasms (OR: 2.15; 95% CI: 1.16–4.00) and respiratory disorders (OR: 3.41; 95% CI: 1.64–7.06). The results for total mortality and specific cause mortality were not influenced by sex, age and smoking status.ConclusionOur study revealed an association between underweight and increased mortality from non-cardiovascular disorders in elderly hypertensive patients in Chinese community. Overweight and obesity were not associated with all cause or cause specific death.

Association of Body Mass Index with All-Cause and Cardiovascular Disease Mortality in the Elderly

“…Underweight was associated with increased mortality in previous studies [21]–[23]. In the present study, underweight was associated with all-cause, CVD, and expanded CVD mortality in the elderly.…”

Body Mass Index and the Risk of Cardiovascular and All-Cause Mortality Among Patients With Hypertension: A Population-Based Prospective Cohort Study Among Adults in Beijing, China

“…In the Minhang Community Study 9 from China, Wang et al obtained information of 10 957 elderly hypertensive patients from an electronic health record system and followed them for a median of 3.7 years. They found that underweight, rather than overweight and obesity, was associated with all-cause mortality.…”

“…6 All major international guidelines recommend weight loss as part of the management of hypertension, but the BMI level associated with lowest mortality in these patients has not previously been well documented. 7 , 8 Wang et al 9 have reported that overweight and obesity were not associated with all-cause mortality in a group of Chinese elderly hypertensive patients. In one retrospective cohort study of adults with hypertension, a U-shaped relationship was observed between BMI and mortality.…”

Higher BMI in Childhood: The Contributory Factor For Type 2 Diabetes and Cardiovascular Disease in Adulthood

“…The CDC recommends losing 5 to 10 percent of current body weight, which can decrease the blood pressure, blood sugar, and cholesterol (Centers for Disease Control and Prevention ,2018). Wang et al (2013) obtained information of 10 957 elderly hypertensive patients from an electronic health record system and followed them for a median of 3.7 years. They found that underweight, rather than overweight and obesity was associated with all-cause mortality.…”