Two-year change in body mass index and subsequent risk of hypertension among men and women in a Taiwan community

Objective To examine the relationship between short-term changes in BMI and the development of hypertension in a cohort of ethnic Chinese men and women. Methods BMI changes between the baseline survey in 1990-1991 and examinations in 1992-1993 were evaluated for 713 men and 853 women aged 35 years or above, free from hypertension, stroke, coronary heart disease and diabetes at the baseline. The incident hypertension and associated risks were assessed in follow-up visits in 2000. Results Both men and women in the highest BMI change quartile had the highest adjusted mean blood pressures at the initial follow-up period. The differences in blood pressure between the extreme quartiles of BMI changes remained significant at the end of follow-up period in men but were notably reduced in women. The risk of incident hypertension increased as the BMI change quartile increased in men (multivariate-adjusted hazard ratio and 95% confidence interval for the highest quartile versus the lowest quartile: 1.81, 1.22-2.68, respectively, P for trend = 0.002). However, in women, the BMI gain effect on hypertension was not significant unless menopausal status was included in the adjustment (hazard ratio and 95% confidence interval: 1.46, 1.04-2.06, respectively). Stratified analyses showed that the BMI change effect was significant only in women in the premenopause or transition to menopause during their BMI change period. Conclusion The 2-year substantial BMI gain is associated with a persistent risk for developing hypertension in men. The risk for women is influenced by their menopause status. J Hypertens 27:1370-1376 (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.