Effects Of Obesity, Smoking And Diabetes On Cardiovascular Disease Risk In Patients With Essential Hypertension

Objective To investigate the association between BMI and the incidence of ischemic stroke in essential hypertensive (EH) patients.Methods A total of 2158 EH patients were divided into EH without ischemic stroke group and EH with ischemic stroke group. Four BMI quartiles were defined based on BMI level (The first quartile:BMI≤22.68kg/m2,n=540;The second quartile:BMI 22.69-24.82kg/m2,n=538;The third quartile:BMI 24.83-26.84 kg/m2,n=541;The fourth quartile:BMI≥26.85 kg/m2 ,n=539) . The incidence of ischemic stroke in four BMI levels was evaluated by multivariable logistic regression analyses.Results(1)The average BMI in EH with ischemic stroke group is lower than that in EH without ischemic stroke group(24.36±3.21 vs 25.15±3.31kg/m2,P<0.001).(2)Form the first quartile to fourth quartile of BMI ,the incidence of ischemic stroke were decreasing(37.6%,34.8%,30.9%,23.0%,P<0.001). With 6.2% (95% CI: 3.3%-9.0%) decreased risk of incidence ischemic stroke per 1 kg/m2 increase of BMI.(3)Compared with the lowest BMI group, the adjusted odds ratio (aOR) for ischemic stroke in the highest BMI group was significantly lower (aOR:0.800,95% CI:0.730-0.875,P<0.001).(4)In male group, comparing with the lowest BMI group, the aOR for ischemic stroke in the highest BMI group was significantly lower(aOR: 0.811,95% CI:0.717-0.918,P=0.001); Similar trend was found in female group (aOR:0.776,95%CI:0.678-0.889,P<0.001).Conclusion Lower BMI was associated with increased incidence of ischemic stroke in EH patients. Objective To investigate the effects of risk factors on incidence of new onset cardiovascular disease(CVD) events in essential hypertensive patients.Methods 380 patients with hypertension were divided into two groups: the event group (n=159) and the non-event group (n=221), according to new onset CVD events during the followed up 10 years.Results(1) The prevalence of new onset CVD events from high to low was stroke (23%), coronary heart disease (22%), death (17%), impaired renal function (15%), cardiac dysfunction (12%) and diabetes mellitus (11%).(2)The mean numbers of CVD risk factors in the event group were significantly higher than that in the non-event group(2.17±1.05 vs 1.36±0.97, P<0.001).(3)The prevalence of old, dyslipidaemia, diabetes mellitus, smoking and early onset cardiovascular family history was significantly higher in the event group than that in the non-event group.(4)After adjustment for age, sex, blood pressure, course of hypertension, pulse pressure and effect of lowering blood pressure, multivariate analysis showed that smoking, diabetes mellitus and dyslipidaemia were the main risk factors of new onset CVD events [OR: 2.667(95%CI:1.499-4.478), 1.854(95%CI:1.027-3.346), 1.657(95%CI:1.028-2.672),respectively].(5) With increasing each risk factor, the risk ratio of new onset CVD event increased 46%.Conclusion Smoking and diabetes are the major risk factors of new onset CVD event in hypertensive patients.