Body weight, weight change, and risk for hypertension in women.
BACKGROUND
Obesity increases the risk for hypertension, but the effects of modest long-term weight changes have not been precisely quantified.


OBJECTIVE
To investigate body mass index (BMI) and weight change in relation to risk for hypertension.


METHODS
Cohort study.


METHODS
General community.


METHODS
Cohort of 82,473 U.S. female nurses 30 to 55 years of age followed every 2 years since 1976. The follow-up rate was 95%.


METHODS
Primary risk factors examined were 1) BMI at age 18 years and midlife and 2) long-term and medium-term weight changes. The outcome was incident cases of hypertension.


RESULTS
By 1992, 16,395 incident cases of hypertension had been diagnosed. After adjustment for multiple covariates, BMI at 18 years of age and midlife were positively associated with occurrence of hypertension (P for trend < 0.001). Long-term weight loss after 18 years of age was related to a significantly lower risk for hypertension, and weight gain dramatically increased the risk for hypertension (compared with weight change < or = 2 kg, multivariate relative risks were 0.85 for a loss of 5.0 to 9.9 kg, 0.74 for a loss > or = 10 kg, 1.74 for a gain of 5.0 to 9.9 kg, and 5.21 for a gain > or = 25.0 kg). Among women in the top tertile of baseline BMI at age 18 years, weight loss had a greater apparent benefit. The association between weight change and risk for hypertension was stronger in younger (< 45 years of age) than older women (> or = 55 years of age). Medium-term weight changes after 1976 showed similar relations to risk for hypertension.


CONCLUSIONS
Excess weight and even modest adult weight gain substantially increase risk for hypertension. Weight loss reduces the risk for hypertension.
Huang
Z
Z
Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Willett
W C
WC
Manson
J E
JE
Rosner
B
B
Stampfer
M J
MJ
Speizer
F E
FE
Colditz
G A
GA
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015430:Weight Gain / Q000502:physiology*; D015431:Weight Loss / Q000502:physiology*