The Association of Body Mass Index With the Risk of Pulmonary Hypertension in Adults: A Systematic Review and Meta-Analysis of Observational Studies

Backgrounds: Findings regarding the association of body mass index (BMI) with pulmonary hypertension (PH) are conflicting, and there is no systematic review and meta-analysis to summarize the results. Therefore, the purpose of this systematic review and meta-analysis is to assess this relationship. Methods: To detect the relevant articles, PubMed, Scopus, and Google Scholar were searched until February 2021. Included essays were pooled using a random-effect model. Cochrane Q-test and I-2-test was applied to assess between-study heterogeneity. Results: Fourteen articles (eight cross-sectional and four cohort studies) were included in the meta-analysis. The meta-analysis of comparing highest vs. lowest BMI categories did not indicate a significant association between BMI and PH (Summary Effect Estimate: 1.59 (95% CI: 0.50, 5.07, I-2 = 92.3). Furthermore, The summary risk estimate for a one-unit increment in BMI was 1.01 (95 % CI: 0.99, 1.03), with high heterogeneity, I-2 = 73.5 %, P heterogeneity < 0.001). Subgroup analysis showed significant positive association between BMI and the risk of PH in studies controlled for cofounders, and studies with higher sample sizes (>= 2,000). Conclusion: There is no significant association between BMI and risk of pulmonary hypertension. Further studies are required to confirm these findings.

Automated summary

Findings regarding the association between body mass index (BMI) and pulmonary hypertension are conflicting. This systematic review and meta-analysis found no significant association between BMI and pulmonary hypertension, but identified a significant positive association in studies controlled for cofounders and with larger sample sizes.