Secular Trends of the Impact of Overweight and Obesity on Hypertension in Yi People: Yi Migrant Study, 1996-2015

Ethnicity Disparities in the Prevalence, Awareness, Treatment, and Control Rates of Hypertension in China

Objectives

Previous studies reported that there were disparities in hypertension management among different ethnic groups, and this study aimed to systematically determine the prevalence, awareness, treatment, and control rates of hypertension in multiple Chinese ethnic groups.

Methods

We searched Embase, PubMed, and Web of Science for articles up to 25 October, 2022. The pooled prevalence, awareness, treatment, and control rates of hypertension were estimated with 95% confidence intervals (CI). The heterogeneity of estimates among studies was assessed by the Cochran Q test and I ² statistic. Meta-regression analyses were conducted to identify the factors influencing the heterogeneity of the pooled prevalence, awareness, treatment, and control rate of hypertension.

Results

In total, 45 publications including 193,788 cases and 587,826 subjects were eligible for the analyses. The lowest prevalence was found in the Han group (27.0%), and the highest prevalence was in the Mongolian population (39.8%). The awareness rates ranged from 24.4% to 58.0% in the four ethnic groups. Both the highest treatment and control rates were found in the Mongolian population (50.6% and 16.0%, respectively), whereas the Yi group had the lowest control rate (8.0%). In addition, the study year, the mean age of subjects, mean body mass index of subjects, tobacco use (%), alcohol use (%), residence (urban%), and education (primary school%) had varied effects on heterogeneity.

Conclusions

These findings highlight the disparities in prevalence, awareness, treatment, and control rates of hypertension in a different ethnic population of China, which could provide suggestions for making targeted prevention measures.

Association of physical activity and heart rate variability in people with overweight and obesity: A systematic review

Background: Obesity is a major public health issue globally which is intrinsically linked to reduced heart rate variability (HRV). Physical inactivity and reduced resting HRV are linked to an increased risk of coronary heart disease, while athletes have a greater HRV. However, the exact correlation between physical activity and HRV remains uncertain. This systematic review aims to collect, report, and critically assess the current scientific literature about the association between physical activity and HRV in individuals with higher weight and obesity. Methods: A systematic search was carried out in electronic databases (Medline/PubMed, SCOPUS and CINAHL Plus) to retrieve studies that evaluated the relationship between physical activity and HRV in individuals with higher weight and obesity. Case-control, longitudinal/cohort, cross-sectional and observational studies were included. Using a critical narrative approach, information about the HRV, and physical activity was extracted and synthesized. The study was registered in PROSPERO: CRD42020208018 on October 9 2020. Results: After removing duplicates, 980 title/abstract records were checked for eligibility, and 12 papers were finally included in the narrative synthesis. The included studies contained physical activity as well as HRV in adults with higher weight or obesity with or without comorbidities. A negative relationship between moderate to vigorous physical activity and HRV indices had been found in two studies. There was also a negative relationship between sedentary time and HF (p = 0.049) and LF/HF (p = 0.036), as well as a positive relationship between sedentary time and LF (p = 0.014). Also dose-response association was found between vigorous exercise and higher SDNN, LF power, and HF power in one of the studies. Conclusions: This systematic review revealed a wide range of responses to physical activity and HRV; however, the current evidence uses a variety of approaches to objectively assess physical activity and measure HRV with different equipment.

Body fat and muscle were associated with metabolically unhealthy phenotypes in normal weight and overweight/obesity in Yi people: A cross-sectional study in Southwest China

This study aimed to determine the association between the absolute mass, distribution, and relative ratio of body fat and muscle with the metabolically unhealthy (MU) phenotypes in normal weight and overweight/obesity in Yi people in China. The cross-sectional data from the Yi Migrants Study was used, which included 3,053 Yi people aged 20-80 years from the rural and urban sets. Participants were classified according to body mass index and metabolic status. Body composition including body fat percentage (BFP), fat mass index (FMI), visceral fat grade (VFG), muscle mass index (MMI), and muscle/fat ratio (M/F) were measured by bioelectrical impedance analysis. Restricted cubic spline and logistics regression models were used to test the associations between body composition parameters with MU phenotypes. Receiver-operating characteristic curves (ROC) were used to analyze the predictive value of MU phenotypes. Among the normal weight and overweight/obesity, 26.31% (497/1,889) and 52.15% (607/1,164) were metabolically unhealthy. Stratified by BMI, covariance analysis showed higher body fat (BFP, FMI, and VFG) and MMI in MU participants than in healthy participants. BFP, FMI, VFG, and MMI were positively associated with MU phenotypes both in normal weight and overweight/obesity after adjustment. M/F was significantly lower than MU participants and was negatively associated with MU phenotypes. BFP, FMI, VFG, and M/F could better predict MU phenotypes than BMI. We concluded that BFP, FMI, and VFG were positively associated with MU phenotypes, while M/F was negatively associated with MU phenotypes across the BMI categories in Yi people. Body fat and muscle measurement could be a valuable approach for obesity management.

Changes in the body mass index and blood pressure association across time: Evidence from multiple cross-sectional and cohort studies

Although body mass index (BMI) is considered a key determinant of high blood pressure, its importance may differ over time and by age group. We utilised separate data sources to investigate temporal changes in this association: 23 independent (newly sampled), repeated cross-sectional studies (Health Survey for England (HSE)) at ≥25 years (1994-2018; N = 126,742); and three British birth cohorts at 43-46 years (born 1946, 1958, and 1970; N = 18,657). In HSE, associations were weaker in more recent years, with this trend most pronounced amongst older adults. After adjustment for sex, anti-hypertensive treatment and education, the mean difference in systolic blood pressure (SBP) per 1 kg/m² increase in BMI amongst adults ≥55 years was 0.75 mmHg (95%CI: 0.60-0.90) in 1994, 0.66 mmHg (0.46-0.85) in 2003, and 0.53 mmHg (0.35-0.71) in 2018. In the 1958 and 1970 cohorts, BMI and SBP associations were of similar magnitude yet weaker in the 1946 cohort, potentially due to differences in blood pressure measurement device. Quantile regression analyses suggested that associations between BMI and SBP were present both below and above the hypertension threshold. A weaker association between BMI and blood pressure may partly offset the public health impacts of increasing obesity prevalence. However, despite sizable increases in use of antihypertensive medication, BMI remains positively associated with SBP in all ages. Our findings highlight the need to tackle non-medical factors such as population diet which influence both BMI and blood pressure, and the utility of using multiple datasets to obtain robust inferences on trends in risk factor-outcome associations across time.