title: Body mass index and all-cause mortality in patients with hypertension.
abstract: OBJECTIVE
  To characterize the relationship between body mass index (BMI) and all-cause mortality among adults with hypertension.
  
  
  METHODS
  We conducted a retrospective cohort study of adults with hypertension from The Health Improvement Network primary care research database in the United Kingdom. Mortality rates within each BMI category were compared after adjustment for age, sex, pre existing medical conditions, smoking, alcohol use, and socioeconomic status.
  
  
  RESULTS
  During a median follow-up period of 8.0 years, 34,354 deaths occurred (8.8%) among the 388,724 study patients. In multivariable analysis that included interaction terms between smoking, heavy alcohol use, preexisting cardiovascular disease and chronic obstructive pulmonary disease (COPD), and BMI category to account for these conditions' association with increased mortality at lower BMI levels, a U-shaped relationship was observed between BMI and mortality, with no difference in mortality in overweight (25.0-29.9 kg/m(2) ) versus normal (18.5-24.9 kg/m(2) ) BMI (risk ratio 1.00, 95% confidence interval 0.95 to 1.04, P = 0.80). In multivariable analysis that used narrower BMI categories, lowest mortality was observed between BMI of 23.0 and 26.9 kg/m(2) .
  
  
  CONCLUSIONS
  Patients with hypertension who have no history of smoking, heavy alcohol use, cardiovascular disease, or COPD have lowest mortality between BMI of 23.0 and 26.9 kg/m(2) .
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA.|Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Wenxin
authors.initials: W
authors.lastname: Xu
authors.affiliation: Division of Endocrinology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Shubina
authors.affiliation: Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Saveli I
authors.initials: SI
authors.lastname: Goldberg
authors.affiliation: Harvard Medical School, Boston, Massachusetts, USA.|Division of Endocrinology, Brigham and Women's Hospital, Boston, Massachusetts, USA.|Harvard Clinical Research Institute, Boston, Massachusetts, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Turchin
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications* / Q000401:mortality; D012189:Retrospective Studies