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Influences of body mass index and physical activity on hypertension and stroke in Korean adult males: 10-year longitudinal study.

ABSTRACT: Hypertension and stroke have been major causes of increased mortality and social and economic burden in Korea. Although physical activity is one of the critical factors for managing adult diseases, studies on the long-term effects are rarely discussed. Therefore, the aim of this study was to elucidate the role of physical activity in hypertension and stroke via a 10-year longitudinal study.Routinely performed health examination data of 5,624,503 Korean men between ages 20 to 70 obtained from the Korean National Health and Nutrition Examination Survey (KNHNES: 2001-2011) were assessed for this study. Data of subjects who met the initial criteria were divided into three groups based on their BMI: normal weight (18.5 to <25.0 kg/m2), overweight (25.0 to <30.0 kg/m2), and obese (≥30.0 kg/ m2) groups. The results were further sub-divided by physical activity frequencies (days/ week). The disease codes for hypertension and stroke were provided by KNHNES for the adjusted relative risks (RR) assessment with the Cox proportional hazard model.Significant RRs of hypertension and stroke were shown in the overweight moderately active group (3 - 4 days/week). In addition, significant RR of hypertension was shown in the normal weight moderately active group. No significance was seen in the obese group in all physical activity frequencies.Regularly performed moderate amount of physical activity may be beneficial in reducing the risk for hypertension and stroke. However, the effects of excessive body weight may override the positive effects of physical activity on the occurrence of hypertension and stroke.

SUBMITTER: Kim Y

PROVIDER: S-EPMC5545205 | biostudies-other | 2017 Jun

REPOSITORIES: biostudies-other

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Project description:ObjectiveWe aimed to assess whether maternal first-trimester low body mass index (BMI) has a protective effect against macrosomia.MethodsThis was a cross-sectional study from January 1, 2011, to June 30, 2021, and 84,900 participants were included. The predictive performance of maternal first-trimester and parental pre-pregnancy BMI for macrosomia was assessed using the area under the receiver-operating characteristics curve (AUC). Multivariate logistic regression analyses were performed to evaluate the independent effect of maternal first-trimester low BMI on macrosomia. Interactions were investigated to evaluate the potential variation of the effect of first-trimester low BMI across different groups. Furthermore, interactions were also examined across groups determined by multiple factors jointly: a) gestational diabetes mellitus (GDM)/GDM history status, parity, and maternal age; and b) GDM/GDM history status, fetal sex, and season of delivery.ResultsThe proportion of macrosomia was 6.14% (5,215 of 84,900). Maternal first-trimester BMI showed the best discrimination of macrosomia (all Delong tests: P < 0.001). The protective effect of maternal first-trimester low BMI against macrosomia remained significant after adjusting for all confounders of this study [adjusted odds ratios (aOR) = 0.37, 95% CI: 0.32-0.43]. Maternal first-trimester low BMI was inversely associated with macrosomia, irrespective of parity, fetal sex, season of delivery, maternal age, and GDM/GDM history status. The protective effect was most pronounced among pregnant women without GDM/GDM history aged 25 to 29 years old, irrespective of parity (multipara: aOR = 0.32, 95% CI: 0.22-0.47; nullipara: aOR = 0.32, 95% CI: 0.24-0.43). In multipara with GDM/GDM history, the protective effect of low BMI was only observed in the 30- to 34-year-old group (aOR = 0.12, 95% CI: 0.02-0.86). For pregnant women without GDM/GDM history, the protective effect of maternal first-trimester low BMI against macrosomia was the weakest in infants born in winter, irrespective of fetal sex (female: aOR = 0.45, 95% CI: 0.29-0.69; male: aOR = 0.39, 95% CI: 0.28-0.55).ConclusionMaternal first-trimester low BMI was inversely associated with macrosomia, and the protective effect was most pronounced among 25- to 29-year-old pregnant women without GDM/GDM history and was only found among 30- to 34-year-old multipara with GDM/GDM history. The protective effect of maternal first-trimester low BMI against macrosomia was the weakest in winter among mothers without GDM/GDM history.

Project description:BackgroundThe study aimed to estimate the incidence of and period of progression to stage 2 hypertension from normal blood pressure.MethodsWe selected a total of 21,172 normotensive individuals between 2003 and 2004 from the National Health Insurance Service-Health Screening and followed them up until 2015. The criteria for blood pressure were based on the American College of Cardiology/American Heart Association 2017 guideline (normal BP: SBP < 120 and DBP < 80 mmHg, elevated BP: SBP 120-129 and DBP < 80 mmHg, stage 1 hypertension: SBP 130-139 or DBP 80-89 mmHg, stage 2 hypertension: SBP ≥140 or DBP ≥ 90 mmHg). We classified the participants into four courses (Course A: normal BP → elevated BP → stage 1 hypertension→ stage 2 hypertension, Course B: normal BP → elevated BP → stage 2 hypertension, Course C: normal BP → stage 1 hypertension → stage 2 hypertension, Course D: normal BP → stage 2 hypertension) according to their progression from normal blood pressure to stage 2 hypertension.ResultsDuring the median 12.23 years of follow-up period, 52.8% (n= 11,168) and 23.6% (n=5004) of the participants had stage 1 and stage 2 hypertension, respectively. In particular, over 60 years old had a 2.8-fold higher incidence of stage 2 hypertension than 40-49 years old. After the follow-up period, 77.5% (n=3879) of participants with stage 2 hypertension were found to be course C (n= 2378) and D (n=1501). After the follow-up period, 77.5% (n=3879) of participants with stage 2 hypertension were found to be course C (n= 2378) and D (n=1501). The mean years of progression from normal blood pressure to stage 2 hypertension were 8.7±2.6 years (course A), 6.1±2.9 years (course B), 7.5±2.8 years (course C) and 3.2±2.0 years, respectively.ConclusionsThis study found that the incidence of hypertension is associated with the progression at each stage. We suggest that the strategies necessary to prevent progression to stage 2 hypertension need to be set differently for each target course.

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Influences of body mass index and physical activity on hypertension and stroke in Korean adult males: 10-year longitudinal study.

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