A two-decade population-based study on the effect of hypertension in the general population with obesity in the United States

Gwyneth  Kon; Yip Han Chin; Jieyu  Lim; Cheng Han  Ng; Shankar  Kannan; Bryan  Chong; Chaoxing  Lin; Kai En  Chan; Vickram Vijay  Anand; Ethan Cheng Zhe  Lee; Shaun  Loong; Zhen Yu  Wong; Chin Meng  Khoo; Mark  Muthiah; Roger  Foo; Georgios K Dimitriadis; Gemma  Figtree; Yibin  Wang; Mark  Chan; Nicholas WS  Chew

doi:10.1002/oby.23658

A two-decade population-based study on the effect of hypertension in the general population with obesity in the United States

Gwyneth Kon, Yip Han Chin, Jieyu Lim, Cheng Han Ng, Shankar Kannan, Bryan Chong, Chaoxing Lin, Kai En Chan, Vickram Vijay Anand, Ethan Cheng Zhe Lee, Shaun Loong, Zhen Yu Wong, Chin Meng Khoo, Mark Muthiah, Roger Foo, Georgios K Dimitriadis, Gemma Figtree, Yibin Wang, Mark Chan, Nicholas WS Chew^*

^*Corresponding author for this work

Diabetes

Research output: Contribution to journal › Article › peer-review

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Abstract

Objective: With rising prevalence of hypertension and obesity, the effect of hypertension in obesity remains an important global issue. The prognosis of the US general population with obesity based on hypertension control was examined. Methods: This study examined participants from the National Health and Nutrition Examination Survey between 1999 and 2018. Individuals with obesity were stratified into no hypertension, controlled hypertension, and uncontrolled hypertension. The study outcome was all-cause mortality. Cox regression of all-cause mortality was adjusted for age, sex, ethnicity, diabetes, and previous myocardial infarction. Results: Of 16,386 individuals with obesity, 53.1% had no hypertension, 24.7% had controlled hypertension, and 22.2% had uncontrolled hypertension. All-cause mortality was significantly higher in uncontrolled hypertension (17.1%), followed by controlled hypertension (14.8%) and no hypertension (4.0%). Uncontrolled hypertension had the highest mortality risk (hazard ratio [HR] 1.34, 95% CI: 1.13-1.59, p = 0.001), followed by controlled hypertension (HR 1.21, 95% CI: 1.10-1.34, p < 0.001), compared with no hypertension after adjustment. The excess mortality trend was more pronounced in females, those with diabetes, and those older than age 65 years. Conclusions: The incremental mortality risk in controlled and uncontrolled hypertension, compared with the normotensive counterparts, irrespective of sex, age, and diabetes status, urges health care providers to optimize hypertension control and advocate weight loss to achieve better outcomes in obesity.

Original language	English
Pages (from-to)	832-840
Number of pages	9
Journal	Obesity
Volume	31
Issue number	3
Early online date	7 Feb 2023
DOIs	https://doi.org/10.1002/oby.23658
Publication status	Published - Mar 2023

Keywords

Obesity
hypertension
Diabetes mellitus type II

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/oby.23658

A Two-Decade Population-Based_KON_Accepted26October2022_GREEN AAMAccepted author manuscript, 614 KB

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Kon, G., Chin, Y. H., Lim, J., Ng, C. H., Kannan, S., Chong, B., Lin, C., Chan, K. E., Anand, V. V., Lee, E. C. Z., Loong, S., Wong, Z. Y., Khoo, C. M., Muthiah, M., Foo, R., Dimitriadis, G. K., Figtree, G., Wang, Y., Chan, M., & Chew, N. WS. (2023). A two-decade population-based study on the effect of hypertension in the general population with obesity in the United States. Obesity, 31(3), 832-840. https://doi.org/10.1002/oby.23658

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title = "A two-decade population-based study on the effect of hypertension in the general population with obesity in the United States",

abstract = "Objective: With rising prevalence of hypertension and obesity, the effect of hypertension in obesity remains an important global issue. The prognosis of the US general population with obesity based on hypertension control was examined. Methods: This study examined participants from the National Health and Nutrition Examination Survey between 1999 and 2018. Individuals with obesity were stratified into no hypertension, controlled hypertension, and uncontrolled hypertension. The study outcome was all-cause mortality. Cox regression of all-cause mortality was adjusted for age, sex, ethnicity, diabetes, and previous myocardial infarction. Results: Of 16,386 individuals with obesity, 53.1% had no hypertension, 24.7% had controlled hypertension, and 22.2% had uncontrolled hypertension. All-cause mortality was significantly higher in uncontrolled hypertension (17.1%), followed by controlled hypertension (14.8%) and no hypertension (4.0%). Uncontrolled hypertension had the highest mortality risk (hazard ratio [HR] 1.34, 95% CI: 1.13-1.59, p = 0.001), followed by controlled hypertension (HR 1.21, 95% CI: 1.10-1.34, p < 0.001), compared with no hypertension after adjustment. The excess mortality trend was more pronounced in females, those with diabetes, and those older than age 65 years. Conclusions: The incremental mortality risk in controlled and uncontrolled hypertension, compared with the normotensive counterparts, irrespective of sex, age, and diabetes status, urges health care providers to optimize hypertension control and advocate weight loss to achieve better outcomes in obesity.",

keywords = "Obesity, hypertension, Diabetes mellitus type II",

author = "Gwyneth Kon and Chin, {Yip Han} and Jieyu Lim and Ng, {Cheng Han} and Shankar Kannan and Bryan Chong and Chaoxing Lin and Chan, {Kai En} and Anand, {Vickram Vijay} and Lee, {Ethan Cheng Zhe} and Shaun Loong and Wong, {Zhen Yu} and Khoo, {Chin Meng} and Mark Muthiah and Roger Foo and Dimitriadis, {Georgios K} and Gemma Figtree and Yibin Wang and Mark Chan and Chew, {Nicholas WS}",

note = "Publisher Copyright: {\textcopyright} 2023 The Obesity Society.",

year = "2023",

month = mar,

doi = "10.1002/oby.23658",

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Kon, G, Chin, YH, Lim, J, Ng, CH, Kannan, S, Chong, B, Lin, C, Chan, KE, Anand, VV, Lee, ECZ, Loong, S, Wong, ZY, Khoo, CM, Muthiah, M, Foo, R, Dimitriadis, GK, Figtree, G, Wang, Y, Chan, M & Chew, NWS 2023, 'A two-decade population-based study on the effect of hypertension in the general population with obesity in the United States', Obesity, vol. 31, no. 3, pp. 832-840. https://doi.org/10.1002/oby.23658

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T1 - A two-decade population-based study on the effect of hypertension in the general population with obesity in the United States

AU - Kon, Gwyneth

AU - Chin, Yip Han

AU - Lim, Jieyu

AU - Ng, Cheng Han

AU - Kannan, Shankar

AU - Chong, Bryan

AU - Lin, Chaoxing

AU - Chan, Kai En

AU - Anand, Vickram Vijay

AU - Lee, Ethan Cheng Zhe

AU - Loong, Shaun

AU - Wong, Zhen Yu

AU - Khoo, Chin Meng

AU - Muthiah, Mark

AU - Foo, Roger

AU - Dimitriadis, Georgios K

AU - Figtree, Gemma

AU - Wang, Yibin

AU - Chan, Mark

AU - Chew, Nicholas WS

PY - 2023/3

Y1 - 2023/3

N2 - Objective: With rising prevalence of hypertension and obesity, the effect of hypertension in obesity remains an important global issue. The prognosis of the US general population with obesity based on hypertension control was examined. Methods: This study examined participants from the National Health and Nutrition Examination Survey between 1999 and 2018. Individuals with obesity were stratified into no hypertension, controlled hypertension, and uncontrolled hypertension. The study outcome was all-cause mortality. Cox regression of all-cause mortality was adjusted for age, sex, ethnicity, diabetes, and previous myocardial infarction. Results: Of 16,386 individuals with obesity, 53.1% had no hypertension, 24.7% had controlled hypertension, and 22.2% had uncontrolled hypertension. All-cause mortality was significantly higher in uncontrolled hypertension (17.1%), followed by controlled hypertension (14.8%) and no hypertension (4.0%). Uncontrolled hypertension had the highest mortality risk (hazard ratio [HR] 1.34, 95% CI: 1.13-1.59, p = 0.001), followed by controlled hypertension (HR 1.21, 95% CI: 1.10-1.34, p < 0.001), compared with no hypertension after adjustment. The excess mortality trend was more pronounced in females, those with diabetes, and those older than age 65 years. Conclusions: The incremental mortality risk in controlled and uncontrolled hypertension, compared with the normotensive counterparts, irrespective of sex, age, and diabetes status, urges health care providers to optimize hypertension control and advocate weight loss to achieve better outcomes in obesity.

AB - Objective: With rising prevalence of hypertension and obesity, the effect of hypertension in obesity remains an important global issue. The prognosis of the US general population with obesity based on hypertension control was examined. Methods: This study examined participants from the National Health and Nutrition Examination Survey between 1999 and 2018. Individuals with obesity were stratified into no hypertension, controlled hypertension, and uncontrolled hypertension. The study outcome was all-cause mortality. Cox regression of all-cause mortality was adjusted for age, sex, ethnicity, diabetes, and previous myocardial infarction. Results: Of 16,386 individuals with obesity, 53.1% had no hypertension, 24.7% had controlled hypertension, and 22.2% had uncontrolled hypertension. All-cause mortality was significantly higher in uncontrolled hypertension (17.1%), followed by controlled hypertension (14.8%) and no hypertension (4.0%). Uncontrolled hypertension had the highest mortality risk (hazard ratio [HR] 1.34, 95% CI: 1.13-1.59, p = 0.001), followed by controlled hypertension (HR 1.21, 95% CI: 1.10-1.34, p < 0.001), compared with no hypertension after adjustment. The excess mortality trend was more pronounced in females, those with diabetes, and those older than age 65 years. Conclusions: The incremental mortality risk in controlled and uncontrolled hypertension, compared with the normotensive counterparts, irrespective of sex, age, and diabetes status, urges health care providers to optimize hypertension control and advocate weight loss to achieve better outcomes in obesity.

KW - Obesity

KW - hypertension

KW - Diabetes mellitus type II

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U2 - 10.1002/oby.23658

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SN - 1930-7381

VL - 31

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JO - Obesity

JF - Obesity

IS - 3

ER -

A two-decade population-based study on the effect of hypertension in the general population with obesity in the United States

Abstract

Keywords

UN SDGs

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