Role of Body Mass Index History in Predicting Risk of the Development of Hypertension in Japanese Individuals

Abstract

It is generally accepted that being overweight or obese increases the risk of the development of hypertension. [1][2][3][4][5][6][7][8][9][10] Also, it has been noted that weight gain increases the risk of hypertension, 1,2,7,[11][12][13][14][15][16][17] whereas weight loss contributes to a reduction in risk. [18][19][20] However, it has not been fully clarified whether overall adiposity in early adulthood such as around age 20 years or at the lifetime maximum would irreversibly confer a residual risk of hypertension after considering the risk associated with current adiposity. In a study of a British birth cohort that analyzed the association of body mass index (BMI) across childhood and adulthood with blood pressure in midadulthood, it was suggested that high BMI and BMI gain at any life stage, especially when recent, were associated with elevated blood pressure levels. 21 A strong positive association between being overweight in early adulthood was reported to be associated with elevated midlife blood pressure levels. 22 To date, only a few large longitudinal studies investigated the role of BMI in early adulthood in the prediction of future hypertension, 7,8,23 and these studies did not clarify the effect of the lifetime maximum BMI (BMImax) on the development of hypertension. In addition, although a few studies suggested that the association between weight gain and incident hypertension tended to be greater in younger than in older participants, 7,24 it remains undetermined whether histories of elevated BMI in early adulthood such as the 20s (BMIage20y) or the BMImax would be positively associated with an increased risk of hypertension even in later life.Therefore, we aimed to investigate the role of BMI histories, including BMI in the early 20s, at its maximum and at the time of baseline examination, as predictors of future hypertension in Japanese individuals. Methods Study ParticipantsThe Toranomon Hospital Health Management Center Study included a cohort consisting mainly of apparently healthy government employees who underwent annual examinations for health screening in Tokyo, Japan. This study included 8142 individuals who underwent a baseline examination during the period from 2003 to 2007 and provided data on blood pressure measurements, a self-reported history of medical treatment for hypertension, or the use of antihypertensive Abstract-It has not been clarified whether overall adiposity in early adulthood or at the lifetime maximum weight would confer a residual risk of hypertension after considering the risk associated with current adiposity. Studied were 6121 Japanese without hypertension. The risk of developing hypertension 4 years after a baseline examination was investigated using the body mass index in the early 20s, at the lifetime maximum, or at the baseline examination. An elevated body mass index at baseline or at the maximum rather than in the early 20s was strongly associated with future hypertension. Compared with individuals with low body mass index both at baseline and in the early...

Body mass index, abdominal adiposity, weight gain and risk of developing hypertension: a systematic review and dose–response meta‐analysis of more than 2.3 million participants

“…S1. We identified 56 prospective cohort studies , whose characteristics are presented in Table S2. One study reported results for two separate cohort studies and was regarded as two different studies .…”

“…Finally, 57 prospective cohort studies with 2,343,466 participants and 216,182 incident cases of HTN were included in meta‐analysis. Twenty studies were from the USA , 13 studies were from Europe , 20 studies were from Asia , 2 studies were from Africa , 1 study was from Mexico and 1 was from Brazil . Baseline characteristics of included studies are presented in Table S2, and reported risk estimates in relation to different categories of anthropometric measures in each study are presented in Table S3.…”

“…Finally, 57 prospective cohort studies with 2,343,466 participants and 216,182 incident cases of HTN were included in meta-analysis. Twenty studies were from the USA (36,39,46,47,50,(52)(53)(54)57,61,63,64,69,77,(81)(82)(83)(84)88,89), 13 studies were from Europe (37,45,49,56,65,71,72,(74)(75)(76)(77)79,80), 20 studies were from Asia (13,(40)(41)(42)(43)(44)55,58,59,62,(66)(67)(68)70,73,78,(85)…”

“…Fifty prospective cohort studies with 2,255,067 participants and 190,320 incident cases of HTN reported results on BMI and risk of developing HTN (13,(36)(37)(38)(39)(40)(41)(43)(44)(45)(46)(47)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(63)(64)(65)(66)(67)(68)70,71,(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83)(84)86,87,89,90). The summary RR for a five-unit increment in BMI was 1.49 (95%CI: 1.41, 1.58), with extreme heterogeneity, I 2 = 97.4%, P heterogeneity-0.0001 (…”

Impact of individual components and their combinations within a family history of hypertension on the incidence of hypertension

“…The study protocol followed the Japanese Government's Ethical Guidelines Regarding Epidemiological Studies in accordance with the Declaration of Helsinki and was reviewed by the Institutional Review Board at Toranomon Hospital. [ 8 ]…”