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.
(In press).
Preview |
Text
O'Neill_1-s2.0-S0091743521003947-main.pdf - Accepted Version Download (1MB) | Preview |
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.
| Type: | Article |
|---|---|
| Title: | Changes in the body mass index and blood pressure association across time: Evidence from multiple cross-sectional and cohort studies |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ypmed.2021.106825 |
| Publisher version: | https://doi.org/10.1016/j.ypmed.2021.106825 |
| Language: | English |
| Additional information: | 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/). |
| Keywords: | Blood pressure, Body mass index, Hypertension, Obesity, Trends |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10135682 |
Archive Staff Only
 |
View Item |
