BMI and lifestyle changes as correlates to changes in self-reported diagnosis of hypertension among older Chinese adults

Nutrition transition theory attributes increased prevalence of high blood pressure to excess body weight associated with lifestyle changes in recent decades. We examined the association of changes in self-reported hypertension diagnoses with changes in body mass index (BMI), health-related behaviors, health status, and social risk factors among older Chinese adults from 1997 to 2006. Data from the longitudinal China Health and Nutrition Survey (CHNS) were analyzed for adults who were age 60 years and older, had a BMI exceeding 18.6 kg/m(2), and reported no diagnosis of hypertension at baseline (n = 1928). Logistic regression models identified factors contributing to staying nonhypertensive or developing hypertension over time. Approximately 17.8% (n = 324) of study participants developed self-reported hypertension, whereas 83.2% (n = 1604) remained without hypertension. Those who stayed overweight or obese or became overweight or obese were more likely to report a new hypertension diagnosis. Incident diagnoses were also observed among those who developed acute conditions, sustained memory loss, or increased their income, whereas remaining nonhypertensive was more likely among rural residents and those who became more physically active and quit drinking alcohol. Study findings provided partial support for the nutrition transition theory whereby changing demographics and lifestyle factors were associated with increases in incident hypertension. J Am Soc Hypertens 2011;5(1):21-30. (c) 2011 American Society of Hypertension. All rights reserved.