【論文摘要】Metabolic Health-body Mass Index Classification and Risk of Having Higher Level of Blood Pressure in Female Young Adults: A Five-year Prospective Cohort Study

Bagas Suryo Bintoro ； Chyi-Huey Bai

《海峽循環醫學雜誌》 1卷2S期 (2019/09) Pp. 40-41

https://doi.org/10.6907/SCJ.201909/SP_1(2).0034

摘要

Background/Synopsis: The American College of Cardiology (ACC)/ American Heart Association (AHA) lowered the blood pressure (BP) thresholds for hypertension (HT) in 2017. The HT definition is close to the definition of for elevated BP as stated by Harmonized criteria for metabolic syndrome (MetS). The MetS is often used as a predictor of metabolic health. There is a subgroup of overweight-obese individuals without MetS, and they were mainly female. Little is known about the hypertension risk among female young adult across the different cross-classification of BMI and metabolic health. Objectives/Purpose: To elucidate the association between BMI-metabolic health cross-classification and BP level among female young adults. Methods/Results: This study employed data from Tw3SHH, a cohort study conducted in Taiwan between 2007 and 2007. Female respondents aged 16-45 y.o, without elevated BP as defined by Harmonized criteria for MetS, and BMI 18.5-30 kg/m^2 at the baseline (n=980) then followed up for five years. BMI category was defined using the Asian cut-off. We defined the metabolically healthy if no MetS components by Harmonized criteria was present. Participants were classified as metabolically healthy normal weight (MHNW), overweight-obese (MHO), metabolically unhealthy normal weight (MUNW), and overweight-obese (MUO). Level of BP as the outcome was defined using 2017 ACC/AHA Guideline. Multivariable ordered logistic regression was performed to see the association between BMI-metabolic health and level of BP in 5 years; the significance level was set at p＜0.05. Covariates were age, total cholesterol, exercise habit, smoking behaviour, alcohol consumption, fatty food consumption, and family history of NCDs. Compared with MHNW, MUNW sub-group was not significantly associated with a higher level of BP in 5 years (odds ratio (OR): 1.35; 0.87 to 2.09). The excess body weight group had significant likelihood increase of the higher level of BP in 5 years (OR for MHO group: 2.14; 1.31 to 3.48; and OR for MUO group: 4.13; 2.78 to 6.12). The pattern persisted after covariates adjustment (OR for MHO group 1.97; 1.19 to 3.23; OR for MUNW group 1.52; 0.97 to 2.39; and OR for MUO group 3.96; 2.65 to 5.91). Conclusion: In female young adults, even in apparently healthy individual defined as having no MetS component, excess body weight increased the likelihood of having a higher level of BP as defined by 2017 ACC/AHA Guidelines. The magnitude increased in unhealthy overweight-obese. The findings implicate that weight reduction should be prioritized for any level of excess body weight.