In populations of African origin, the positive association between blood pressure and body mass index diminishes as population BMI increases, with the systolic slope decreasing by 0.10 per unit increase in mean BMI.
Cross-Sectional (n=18,072)
Yes
In populations of African descent, the positive association between BMI and blood pressure weakens at higher levels of BMI, suggesting that increases in fat mass relative to lean mass may have a diminishing effect on blood pressure.
Effect estimate: Coefficient -0.10 (95% CI -0.15 to -0.06)
BACKGROUND: Blood pressure is directly and causally associated with body mass index (BMI) in populations worldwide. However, the relationship may vary across BMI in populations of African origin. METHODS: We compared the relationship between blood pressure and BMI in populations of African origin, using 13 samples from Africa, the Caribbean, the United Kingdom and the United States. We had access to data from individual participants for age, height, weight, blood pressure, and treatment of hypertension. Analysis was restricted to 18,072 participants (age 35-64 years; 44% men). We carried out multivariate regression analysis to estimate the relationship between blood pressure and BMI by country and by sex. The use of antihypertensive treatment was taken into account by exclusion and by sensitivity analysis. RESULTS: There was a positive relationship between both systolic and diastolic blood pressure and BMI. In men the slopes for systolic blood pressure varied from 0.27 mm Hg per kg/m (95% confidence interval = -0.01 to 0.56) in the United States to 1.72 mm Hg per kg/m (95% confidence interval = 0.92 to 2.53) in Ghana (Kumasi). In women, the slopes varied from 0.08 (-0.54 to 0.72) in South Africa to 1.32 (0.98 to 1.66) in the Republic of Congo. Similar variation in trends was seen for diastolic blood pressure. The higher the BMI, the shallower the slopes -0.10 (-0.15 to -0.06) for systolic, -0.09 (-0.12 to -0.06) for diastolic. No differences were seen after excluding persons who were being treated for hypertension. CONCLUSIONS: Blood pressure and BMI levels vary among populations of the African diaspora. The effect of BMI on blood pressure levels diminishes as BMI increases. These results suggest a complex relationship among excess body weight, adiposity, and energy expenditure.
Cappuccio et al. (Tue,) conducted a cross-sectional in Hypertension (n=18,072). Body Mass Index (BMI) was evaluated on Change in systolic blood pressure slope per unit increase in mean population BMI (Coefficient -0.10, 95% CI -0.15 to -0.06). In populations of African origin, the positive association between blood pressure and body mass index diminishes as population BMI increases, with the systolic slope decreasing by 0.10 per unit increase in mean BMI.