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A Two-Decade Population-Based Study on the Effect of Hypertension in the General Population with Obesity in the United States

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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

Original languageEnglish
Accepted/In press26 Oct 2022

King's Authors


With rising prevalence of hypertension and obesity, the effect of hypertension in obesity remains an important global issue. We examined the prognosis of the US general population with obesity based on hypertension
This study examined participants from the National Health and Nutrition Examination Survey (NHANES) between 1999-2018. Patients with obesity were stratified into no hypertension, controlled hypertension, 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.
Of 16,386 patients 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 (HR1.34, 95%CI:1.13-1.59, p=0.001), followed by controlled hypertension
(HR1.21, 95%CI:1.10-1.34, ptrend was more pronounced in females, those with diabetes and those over 65 years.
The incremental mortality risk in controlled and uncontrolled hypertension, compared to the normotensive counterparts, irrespective of sex, age and diabetes status, urges healthcare providers to optimise hypertension
control and advocate weight loss to achieve better outcomes in obesity.

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