Body mass index, hypertension and 5-year coronary heart disease incidence in middle aged men: the PRIME study.
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.
Mahamat
Aba
A
MONICA-Lille, INSERM U 508, Institut Pasteur de Lille, 1 rue du Prof. Calmette, 59019 Lille Cedex, France.
Richard
Florence
F
Arveiler
Dominique
D
Bongard
Vanina
V
Yarnell
John
J
Ducimetière
Pierre
P
Ruidavets
Jean-Bernard
JB
Haas
Bernadette
B
Bingham
Annie
A
Evans
Alun
A
Amouyel
Philippe
P
Dallongeville
Jean
J
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