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  • Title: Associations of body mass index with incident hypertension in American white, American black and Chinese Asian adults in early and middle adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) study, the Atherosclerosis Risk in Communities (ARIC) study and the People's Republic of China (PRC) study.
    Author: Katz EG, Stevens J, Truesdale KP, Cai J, North KE, Steffen LM.
    Journal: Asia Pac J Clin Nutr; 2013; 22(4):626-34. PubMed ID: 24231024.
    Abstract:
    The association of body mass index (BMI) with blood pressure may be stronger in Asian than non-Asian populations, however, longitudinal studies with direct comparisons between ethnicities are lacking. We compared the relationship of BMI with incident hypertension over approximately 9.5 years of follow-up in young (24-39 years) and middle-aged (45-64 years) Chinese Asians (n=5354), American Blacks (n=6076) and American Whites (n=13451). We estimated risk differences using logistic regression models and calculated adjusted incidences and incidence differences. To facilitate comparisons across ethnicities, standardized estimates were calculated using mean covariate values for age, sex, smoking, education and field center, and included the quadratic terms for BMI and age. Weighted least-squares regression models with were constructed to summarize ethnic-specific incidence differences across BMI. Wald statistics and p-values were calculated based on chi-square distributions. The association of BMI with the incidence difference for hypertension was steeper in Chinese (p<0.05) than in American populations during young and middle-adulthood. For example, at a BMI of 25 vs 21 kg/m2 the adjusted incidence differences per 1000 persons (95% CI) in young adults with a BMI of 25 vs those with a BMI of 21 was 83 (36- 130) for Chinese, 50 (26-74) for Blacks and 30 (12-48) for Whites; among middle-aged adults it was 137 (77-198) for Chinese, 49 (9-88) for Blacks and 54 (38-69) for Whites. Whether hypertension carries the same level of risk of stroke or cardiovascular disease across national or ethnic groups remains uncertain. 比起非亞裔人群，亞洲人之身體質量指數(BMI)與血壓有較密切之相關性。然 而，直接比較種族間差異的縱貫性研究尚顯不足。本篇研究主要比較，年輕 (24-39 歲)和中年(45-64 歲)的中國亞洲人(5354 人)、美國黑人(6076 人)與白人 (13451 人)之BMI 與追蹤約9.5 年間高血壓發生率之關聯。本研究利用邏輯斯 迴歸模式估計風險差，並計算調整後發生率與發生率差。為使種族間比較更具 意義，同時校正了共變項，包括年齡、性別、抽菸、教育程度和研究地區，加 上BMI 與年齡的平方項。以加權最小平方迴歸模式統合分析不同BMI 之間， 特定族群發生率之差異。根據卡方分佈進行Wald 統計分析並計算p 值。在成 人早期與中期，中國人BMI 與高血壓發生風險之差異較美國人大(p<0.05)。舉 例來說，年輕成人BMI 為25 與21 之調整發生率差，中國人每千人是83 (36- 130)、美國黑人50 (26-74)，而白人為30 (12-48)；而對中年人來說，中國人每 千人是137 (77-198)、美國黑人49 (9-88)、白人54 (38-69)。然而，高血壓對於 未來中風或心血管疾病發生之風險影響，在不同國家或種族之間是否有差異， 仍舊不確定。
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