Key result
Subjects diagnosed with hypertension or diabetes by age 50 had a significantly greater increase in body mass index over 15 years compared to healthy controls (mean difference 0.73 kg/m2), despite periodic health examinations.
Why the study?
Do periodic health examinations prevent untoward increases in BMI and blood pressure in subjects at risk for or diagnosed with hypertension and diabetes compared to healthy controls?
Cohort (n=943)
No
Do periodic health examinations prevent untoward increases in BMI and blood pressure in subjects at risk for or diagnosed with hypertension and diabetes compared to healthy controls?
Mean Difference: 0.73 (95% CI 0.36–1.11)
Absolute Event Rate: 2.4% vs 1.7%
p-value: p=<0.001
Periodic health examinations every 5 years were insufficient to prevent significant increases in BMI and blood pressure over a 15-year period in patients who eventually developed hypertension or diabetes.
Periodic exams may be insufficient to curb BMI gains in those developing hypertension or diabetes; leaves open whether intensified prevention before age 50 alters trajectories.
BACKGROUND: Obesity is a significant risk factor for hypertension and diabetes. A cohort of 50-year-old voluntary periodic health examination (PHE) participants was analyzed 15 years retrospectively. Our aim was to evaluate changes in body mass index (BMI) and blood pressure in subjects diagnosed with hypertension and/or diabetes in comparison with healthy controls. METHODS: Voluntary periodic health examinations (PHE) of the citizens have been carried out by the city of Tampere, Finland. Health data, including body mass index (BMI) and blood pressure, were recorded every five years, starting at the age of 35 (baseline). A total of 339 subjects from the 50-year-old cohort having hypertension and/or diabetes were chosen to the study group. The control group included 604 subjects from the 50-year-old cohort who had the same follow-up information but were not diagnosed with hypertension and/or diabetes. RESULTS: In the study group the mean BMI had increased from 26.1 at baseline to 28.5 at the final 15-year follow-up examination. The corresponding increase in the control group was from 23.8 at baseline to 25.5 at the final follow-up. The difference in change with time between the groups was statistically significant (p = 0.04). On the average, the controls gained 4.9 kilograms, whereas subjects in the study group gained 7.0 kilograms over the 15 years of follow-up. Systolic and diastolic blood pressures were also higher in the study group already at baseline and systolic blood pressure increased with time more in the study group than in the control group (p = 0.004). CONCLUSIONS: BMI and blood pressure were higher in the study group in comparison with the controls already at baseline at 35 years, and the differences were not favorably changed during the follow-up. Apparently, the effect of PHE had not been as efficient as planned on subjects in the study group, who were already slightly overweight at baseline.
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Kunnas et al. (2012) conducted a cohort in Hypertension and/or diabetes (n=943). Diagnosis of hypertension and/or diabetes by age 50 vs. Healthy controls without hypertension and/or diabetes was evaluated on Change in body mass index (BMI) over 15 years (MD 0.73, 95% CI 0.36-1.11, p=<0.001). Subjects diagnosed with hypertension or diabetes by age 50 had a significantly greater increase in body mass index over 15 years compared to healthy controls (mean difference 0.73 kg/m2), despite periodic health examinations.
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