Abstract
OBJECTIVES: To assess the extent of interaction between body mass index (BMI) and triglyceride (TG) level and its effects on blood pressure (BP) in elderly individuals in China. DESIGN: Cross-sectional study. SETTING: Data were taken from a cross-sectional study called the China Health and Retirement Longitudinal Study. PARTICIPANTS: The analytic sample included 3629 subjects aged 45 to 96 years. MAIN OUTCOME MEASUREMENTS: Data were obtained from the China Health and Retirement Longitudinal Study, which is a cross-sectional study. Age-adjusted partial Pearson's correlation test was used to compare various characteristics and BP. Adjusted associations were first used as linear regression models, as appropriate. Then, general linear models adjusted for related potential confounders were used to examine the synergistic effects of BMI and TG level on BP. Finally, a binary logistic regression model adjusted for confounding factors was used to examine the association between BMI or TG level and hypertension. RESULTS: Age-adjusted partial Pearson's correlation coefficient showed that the TG level was positively correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both men and women with BMI < 24.0 kg/m(2); however, TG level was positively correlated with DBP in women with BMI ≥ 24.0 kg/m(2) but not with DBP in men with BMI ≥ 24.0 kg/m(2). Multiple linear regression analysis showed that BMI level was significantly and positively associated with both SBP and DBP in men and women with BMI < 24.0 kg/m(2), and TG level was significantly and positively associated with SBP in women with BMI < 24.0 kg/m(2), independent of other confounding factors. A general linear model analysis with adjustment for confounding factors (age, educational level, marital status, current residence, smoking, eating habits, taking activities, antidiabetic medication, antihypertensive therapy, fasting plasma glucose [FPG], low-density lipoprotein cholesterol [LDL-C], estimated glomerular filtration rate [eGFR], and serum uric acid [SUA]) showed no interaction between BMI and TG level and SBP (men, β = 0.572, P = 0.845; women, β = 0.122, P = 0.923) and DBP (men, β = -0.373, P = 0.810; women, β = 0.272, P = 0.828). A binary logistic regression model analysis with adjustment for confounding factors (age, educational level, marital status, current residence, smoking, drinking, eating habits, taking activities, major accidental injury, physical activity, history of cardiovascular disease, history of liver disease, antilipidemic medication, antidiabetic medication, antihypertensive therapy, FPG, LDL-C, high-density lipoprotein cholesterol [HDL-C], eGFR, and SUA) showed that overweight and obese men and women were more likely to have hypertension (men: odds ratio [OR] = 1.781, 95% confidence interval [CI] = 1.393-2.277; women: OR = 1.653, 95% CI = 1.330-2.055) and women with high TG were more likely to have hypertension (OR = 1.558, 95% CI = 1.219-1.992). CONCLUSION: An interactive effect of BMI and TG level on BP was not observed in either men or women; however, independent effects of BMI on BP were observed in both men and women, and an association between TG level and hypertension was observed in women.