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Open AccessArticle

Association between Body Mass Index and All-Cause Mortality in Hypertensive Adults: Results from the China Stroke Primary Prevention Trial (CSPPT)

Department of Cardiology, Peking University First Hospital, Beijing 100034, China
National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
Institute for Biomedicine, Anhui Medical University, Hefei 230032, China
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
Author to whom correspondence should be addressed.
Nutrients 2016, 8(6), 384;
Received: 11 April 2016 / Revised: 9 June 2016 / Accepted: 15 June 2016 / Published: 22 June 2016
(This article belongs to the Special Issue Metabolically Healthy Obesity)
The association between elevated body mass index (BMI) and risk of death has been reported in many studies. However, the association between BMI and all-cause mortality for hypertensive Chinese adults remains unclear. We conducted a post-hoc analysis using data from the China Stroke Primary Prevention Trial (CSPPT). Cox regression analysis was performed to determine the significance of the association of BMI with all-cause mortality. During a mean follow-up duration of 4.5 years, 622 deaths (3.0%) occurred among the 20,694 participants aged 45–75 years. A reversed J-shaped relationship was observed between BMI and all-cause mortality. The hazard ratios (HRs) for underweight (<18.5 kg/m2), overweight (24.0–27.9 kg/m2), and obesity (≥28.0 kg/m2) were calculated relative to normal weight (18.5–23.9 kg/m2). The summary HRs were 1.56 (95% CI, 1.11–2.18) for underweight, 0.78 (95% CI 0.64–0.95) for overweight and 0.64 (95% CI, 0.48–0.85) for obesity. In sex-age-specific analyses, participants over 60 years of age had optimal BMI in the obesity classification and the results were consistent in both males and females. Relative to normal weight, underweight was associated with significantly higher mortality. Excessive weight was not associated with increased risk of mortality. Chinese hypertensive adults had the lowest mortality in grade 1 obesity. View Full-Text
Keywords: obesity; body mass index; mortality; hypertension; China obesity; body mass index; mortality; hypertension; China
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Yang, W.; Li, J.-P.; Zhang, Y.; Fan, F.-F.; Xu, X.-P.; Wang, B.-Y.; Xu, X.; Qin, X.-H.; Xing, H.-X.; Tang, G.-F.; Zhou, Z.-Y.; Gu, D.-F.; Zhao, D.; Huo, Y. Association between Body Mass Index and All-Cause Mortality in Hypertensive Adults: Results from the China Stroke Primary Prevention Trial (CSPPT). Nutrients 2016, 8, 384.

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