eprintid: 10135682
rev_number: 20
eprint_status: archive
userid: 608
dir: disk0/10/13/56/82
datestamp: 2021-10-05 15:22:53
lastmod: 2021-12-02 00:29:51
status_changed: 2021-10-05 15:22:53
type: article
metadata_visibility: show
creators_name: Bann, D
creators_name: Scholes, S
creators_name: Hardy, R
creators_name: O'Neill, D
title: Changes in the body mass index and blood pressure association across time: Evidence from multiple cross-sectional and cohort studies
ispublished: inpress
divisions: UCL
divisions: B16
divisions: B14
divisions: J81
divisions: B02
keywords: Blood pressure, Body mass index, Hypertension, Obesity, Trends
note: This is an Open Access article published under a Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) Licence (https://creativecommons.org/licenses/by-nc-nd/4.0/).
abstract: Although body mass index (BMI) is considered a key determinant of high blood pressure, its importance may differ over time and by age group. We utilised separate data sources to investigate temporal changes in this association: 23 independent (newly sampled), repeated cross-sectional studies (Health Survey for England (HSE)) at ≥25 years (1994-2018; N = 126,742); and three British birth cohorts at 43-46 years (born 1946, 1958, and 1970; N = 18,657). In HSE, associations were weaker in more recent years, with this trend most pronounced amongst older adults. After adjustment for sex, anti-hypertensive treatment and education, the mean difference in systolic blood pressure (SBP) per 1 kg/m2 increase in BMI amongst adults ≥55 years was 0.75 mmHg (95%CI: 0.60-0.90) in 1994, 0.66 mmHg (0.46-0.85) in 2003, and 0.53 mmHg (0.35-0.71) in 2018. In the 1958 and 1970 cohorts, BMI and SBP associations were of similar magnitude yet weaker in the 1946 cohort, potentially due to differences in blood pressure measurement device. Quantile regression analyses suggested that associations between BMI and SBP were present both below and above the hypertension threshold. A weaker association between BMI and blood pressure may partly offset the public health impacts of increasing obesity prevalence. However, despite sizable increases in use of antihypertensive medication, BMI remains positively associated with SBP in all ages. Our findings highlight the need to tackle non-medical factors such as population diet which influence both BMI and blood pressure and the utility of using multiple datasets to obtain robust inferences on trends in risk factor-outcome associations across time.
date: 2021-09-30
date_type: published
official_url: https://doi.org/10.1016/j.ypmed.2021.106825
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1891656
doi: 10.1016/j.ypmed.2021.106825
pii: S0091-7435(21)00394-7
lyricists_name: Bann, David
lyricists_name: Hardy, Rebecca
lyricists_name: O'Neill, Dara
lyricists_name: Scholes, Shaun
lyricists_id: DBANN02
lyricists_id: RHARD63
lyricists_id: DONEI20
lyricists_id: SSCHO95
actors_name: Allington-Smith, Dominic
actors_id: DAALL44
actors_role: owner
full_text_status: public
publication: Preventive Medicine
article_number: 106825
event_location: United States
citation:        Bann, D;    Scholes, S;    Hardy, R;    O'Neill, D;      (2021)    Changes in the body mass index and blood pressure association across time: Evidence from multiple cross-sectional and cohort studies.                   Preventive Medicine      , Article 106825.  10.1016/j.ypmed.2021.106825 <https://doi.org/10.1016/j.ypmed.2021.106825>.    (In press).    Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10135682/3/O%27Neill_1-s2.0-S0091743521003947-main.pdf