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Original research
Relationship between body mass index and ischaemic stroke in Chinese elderly hypertensive patients
  1. Jiayi Huang1,
  2. Lin Liu1,
  3. Yu-Ling Yu1,
  4. Chao-Lei Chen1,
  5. Kenneth Lo1,2,
  6. Yu-Qing Huang1,
  7. Song-tao Tang3,
  8. Ying Qing Feng1
  1. 1 Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Academy of Medical Sciences, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, School of Medicine, South China University of Technology, Guangzhou, China
  2. 2 Department of Epidemiology, Centre for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, Rhode Island, USA
  3. 3 Community Health Center of Liaobu County, Dongguan, China
  1. Correspondence to Professor Ying Qing Feng, Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, School of Medicine, South China University of Technology, Guangzhou 510080, China; 651792209{at}qq.com; Dr Song-tao Tang, Community Health Center of Liaobu County, Dongguan, China; 3038384760{at}qq.com

Abstract

Background Despite obesity being a major risk factor for ischaemic stroke (IS), the association between body mass index (BMI) and IS in patients with hypertension remains uncertain.

Objective To assess the association between BMI and IS among elderly hypertensive patients in China.

Methods and results We recruited 3500 hypertensive patients aged ≥60 between 1 January 2010 and 31 December 2011 in China and ascertained their stroke status until December 2016. Multivariate Cox regression was used to evaluate the association between BMI and IS with interaction tests for exposure and covariates. A total of 3315 subjects (mean age 71.41±7.20 years, 44.5% were men) were included for data analysis. During an average follow-up period of 5.5 years, there were 206 onset cases (6.21%) of IS. When BMI was treated as a continuous variable, it was positively associated with the incidence of new onset IS (HR=1.14; 95% CI: 1.05 to 1.34; p=0.005) after adjusting for potential confounders. Meanwhile, when BMI was treated as a categorical variable, the highest category (≥28 kg/m2) was strongly associated with an increased risk for IS compared with normal BMI category (18.5 to 24 kg/m2) (HR=1.36, 95% CI: 1.09 to 1.80; p<0.001) in the fully adjusted model. Subgroup and interaction analysis also demonstrated that BMI independently associated with IS among males, smokers, alcohol drinkers, diabetic patients, people with uncontrolled blood pressure, decreased estimated glomerular filtration rate and those aged ≥70 years.

Conclusion BMI was significantly associated with IS and was an independent risk of IS in Chinese elderly hypertensive patients.

  • hypertension
  • stroke medicine

http://dx.doi.org/10.1136/postgradmedj-2019-137457

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    Footnotes

    • Correction notice This article has been corrected since it appeared Online First. The correspondence address has been corrected.

    • Contributors JH drafted the manuscript. LL and Y-QH helped with the statistical analysis. Y-QF, KL and JH participated in the design of the study and revised the manuscript. JH, LL, C-LC, Y-LY and S-TT participated in data collection. All authors read and approved the final manuscript.

    • Funding This work was supported by the Science and Technology Program of Guangdong Province (No. 2017B030314041), the Science and Technology Program of Guangzhou (No. 201604020143, No. 201604020018, No. 201604020186, No. 201510010254 and No. 201803040012) and the National Key Research and Development Program of China (No. 2017YFC1307603, No. 2016YFC1301305), the Key Area R&D Program of Guangdong Province (No. 2019B020227005).

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval This study was in compliance with the principles outlined in the Declaration of Helsinki and was approved by the institutional medical ethical committee of the Guangdong General Hospital, Guangzhou, China.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request for corresponding author.