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Original research article
Association of 6-year waist circumference gain and incident hypertension
  1. Yang Zhao1,
  2. Ming Zhang2,3,
  3. Xinping Luo2,3,
  4. Chongjian Wang1,
  5. Linlin Li1,
  6. Lu Zhang1,2,3,
  7. Bingyuan Wang1,2,3,
  8. Yongcheng Ren1,2,3,
  9. Junmei Zhou2,3,
  10. Chengyi Han1,2,3,
  11. Chao Pang4,
  12. Lei Yin4,
  13. Tianping Feng4,
  14. Jingzhi Zhao4,
  15. Dongsheng Hu1
  1. 1 Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, Republic of China
  2. 2 Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen,Guangdong, Republic of China
  3. 3 The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, Republic of China
  4. 4 Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, Republic of China
  1. Correspondence to Professor Dongsheng Hu, Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; hud{at}


Objective The risk of incident hypertension with gain in waist circumference (WC) has not been fully addressed among Chinese adults.

Methods A total of 10 265 non-hypertensive participants ≥18 years old who underwent health examinations in rural China were recruited in 2007–2008 and followed up in 2013–2014. Participants were classified by gender according to categories of per cent WC gain at follow-up: ≤−2.5%, −2.5% to 2.5%, 2.5% to 5% and >5%. Relative risk (RR) and 95% CI values for effect of WC gain on the incident hypertension were calculated by using modified Poisson regression models.

Results During 6 years of follow-up, we identified 2027 hypertension cases (1213 women). From baseline to follow-up, the prevalence of abdominal obesity increased from 21.1% to 29.6% for men and 49.8% to 61.9% for women. As compared with participants who were not abdominally obese at both baseline and follow-up, both genders who were abdominally obese at follow-up showed greater risk of hypertension regardless of abdominal obesity status at baseline. Compared with the reference group of −2.5% to 2.5% change in WC, with >5% WC gain, risk of incident hypertension was increased for men (RR=1.34, 95% CI 1.15 to 1.57) and women (RR=1.28, 95% CI 1.10 to 1.50). The hypertension risk decreased for men with WC loss ≥2.5% (RR=0.81, 95% CI 0.67 to 0.98).

Conclusions Abdominal obesity is seriously prevalent in China. The risk of hypertension increased significantly with increasing WC for both genders in a rural Chinese population.

  • Hypertension
  • Obesity
  • Epidemiology

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  • Contributors All authors were involved in the collection of data and approved the final version of the manuscript.

  • Funding This study was supported by the National Natural Science Foundation of China (No. 81373074 and 81402752), Science and Technology Development Foundation of Shenzhen (No. JCYJ20140418091413562) and Natural Science Foundation of Shenzhen University (No. 2 01 404).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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