Skip to main content
main-content

01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Change in the association of body mass index and systolic blood pressure in Germany – national cross-sectional surveys 1998 and 2008–2011

Zeitschrift:
BMC Public Health > Ausgabe 1/2015
Autoren:
Carolin Adler, Angelika Schaffrath Rosario, Claudia Diederichs, Hannelore K. Neuhauser
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-015-2023-8) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

All authors contributed to the overall conception of the study. CA performed the statistical analyses and drafted the main manuscript. HN drafted parts of the manuscript, gave advice regarding the statistical analysis and was involved in the interpretation of the data and results. ASR provided statistical expertise for the data analysis and revised the manuscript. CD was concerned with the interpretation of the results and revised the manuscript. All authors read and approved the final manuscript.

Abstract

Background

A recent weakening and even decoupling of the association of body mass index (BMI) and systolic blood pressure (SBP) in population data was reported, i. a. for Western Europe.

Methods

The association of BMI and SBP in recent cross-sectional population data from Germany was investigated in participants aged 18–79 years with BMI 17.5-40 kg/m2 from national health examination surveys 1998 (n = 6,931) and 2008–2011 (n = 6,861) in Germany. The association was analyzed both in the overall samples and in participants without antihypertensive medication.

Results

From 1998 to 2008–11, age- and sex-standardized mean SBP decreased from 129.0 (CI 128.2-129.7) to 124.1 (123.5-124.6) mmHg in all participants and from 126.0 (125.4-126.7) to 122.3 (121.7-122.8) mmHg among persons not on antihypertensive medication. The proportion of persons treated with antihypertensives augmented from 19.2 % (17.7-20.8) to 25.3 % (24.0-26.6). Mean BMI remained constant at around 27 kg/m2 with a slight increase in obesity prevalence. BMI was positively associated with SBP both in 1998 and 2008–11, yet the association tended to level out with increasing BMI suggesting a non-linear association. The strength of the BMI-SBP-association decreased over time in all and untreated men. In women, the association weakened in the overall sample, but remained similarly strong in untreated women. The unadjusted linear regression models were used to estimate the increase in SBP within 5-unit BMI increases. E. g. for men in 1998, SBP was higher by 7.0 mmHg for a BMI increase from 20 to 25 kg/m2 and by 3.6 mmHg for BMI 30 to 35 kg/m2. The corresponding values for 2008–11 were 3.8 mmHg and 1.7 mmHg.

Conclusions

The cross-sectional association of BMI and SBP decreased between 1998 and 2008–11 in Germany, however it did not disappear and it is in part explained by improvements in the diagnosis and treatment of high blood pressure.
Zusatzmaterial
Additional file 1. Unadjusted association between BMI and systolic blood pressure in 1998 and 2008–11 stratified by age. The combined models include survey year. Survey was coded as 0 = 1998, 1 = 2008–11. The table displays the unadjusted association of BMI with SBP for the age groups 18–39 years, 40–59 years and 60–79 years separately for 1998 and 2008–11 and in a combined dataset of both surveys.
12889_2015_2023_MOESM1_ESM.xlsx
Additional file 2. Association of BMI with systolic blood pressure in different age groups from age-group specific linear regression models including BMI and BMI squared. The range between the 5th and 95th BMI percentile for each age group is plotted. The p-value is the combined p for the interaction terms of age-group with BMI and with BMI squared from the respective model including all age-groups. The figure illustrates the predicted SBP derived from unadjusted linear regression models including BMI and BMI2 stratified by age groups 18–39, 40–59 and 60–79 years plotted against narrow BMI steps ranging from the 5th to the 95th BMI percentile for each age group. (PDF 34 kb)
12889_2015_2023_MOESM2_ESM.pdf
Additional file 3. Unadjusted association between BMI and systolic blood pressure in untreated hypertensives in 1998 and 2008–11. The combined models include survey year. Survey was coded as 0 = 1998, 1 = 2008–11. The table displays the unadjusted association of BMI with SBP in untreated persons with hypertension separately for 1998 and 2008–11 and in a combined dataset of both surveys.
12889_2015_2023_MOESM3_ESM.xlsx
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2015

BMC Public Health 1/2015 Zur Ausgabe