title: Body mass index, hypertension and 5-year coronary heart disease incidence in middle aged men: the PRIME study.
abstract: OBJECTIVE
  The aim of the present study was to assess the joint contribution of hypertension and body mass index to coronary heart disease risk. DESIGN Prospective study on men aged 50-59 years free of coronary heart disease at entry recruited in three regions of France (n = 7359) and in Northern Ireland (n = 2399).
  
  
  METHODS
  The recruitment frame was based on industry and various employment groups, on health screening centers and general practice.
  
  
  RESULTS
  Incident cases of effort angina, unstable angina, myocardial infarction and coronary death were recorded over a 5-year follow-up.
  
  
  RESULTS
  Compared with the reference group [body mass index (BMI) 25 kg/m2], the relative risk of coronary event was higher in the second (25 < or =BMI 27.6) and third BMI tertiles: 1.27 (95% confidence interval 0.94-1.70) and 1.14 (0.84-1.56) after adjustment for confounders and covariates, including diabetes, hypertension and lipoprotein levels. Further analyses revealed a significant interaction between hypertension and BMI on coronary disease risk (P <0.05), suggesting that hypertension modifies coronary heart disease (CHD) risk attributable to BMI. Among hypertensive men, the relative risk of coronary heart disease was 1.34 (0.85-2.11) and 1.61 (1.04-2.50) in the second and third BMI tertiles, respectively. In normotensive men, BMI was not associated with CHD risk; relative risk 1.25 (0.85-1.85) and 0.66 (0.40-1.09) in the second and third BMI, respectively.
  
  
  CONCLUSIONS
  These results indicate that hypertension and overweight jointly increase coronary heart disease risk.
authors.affiliation: MONICA-Lille, INSERM U 508, Institut Pasteur de Lille, 1 rue du Prof. Calmette, 59019 Lille Cedex, France.
authors.forename: Aba
authors.initials: A
authors.lastname: Mahamat
authors.forename: Florence
authors.initials: F
authors.lastname: Richard
authors.forename: Dominique
authors.initials: D
authors.lastname: Arveiler
authors.forename: Vanina
authors.initials: V
authors.lastname: Bongard
authors.forename: John
authors.initials: J
authors.lastname: Yarnell
authors.forename: Pierre
authors.initials: P
authors.lastname: Ducimetière
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Ruidavets
authors.forename: Bernadette
authors.initials: B
authors.lastname: Haas
authors.forename: Annie
authors.initials: A
authors.lastname: Bingham
authors.forename: Alun
authors.initials: A
authors.lastname: Evans
authors.forename: Philippe
authors.initials: P
authors.lastname: Amouyel
authors.forename: Jean
authors.initials: J
authors.lastname: Dallongeville
mesh_terms: D015992:Body Mass Index; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D005602:France / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D012307:Risk Factors