Weight change and the risk of cardiovascular disease in patients with hypertension: A primary-care cohort study

Background: Weight control is a cornerstone of hypertension management. Therefore, it is important to understand the relationship of weight change to risk of cardiovascular disease (CVD) among patients with hypertension. We aimed to investigate the association of weight change with the risk of CVD, stroke, and myocardial infarction (MI) among patients with hypertension.

Methods: We obtained the data from medical records of the Hypertension Health Management Program (HMPH) in Shenzhen, China. The present study included 221 454 individuals with hypertension. Weight change over two years was divided into loss ≥10%, loss 5-10%, stable (-5 ~ 5%), gain 5-10%, and gain >10%. Cox regression analyses were applied to assess the associations of weight change groups with the risk of CVD, stroke, and MI.

Results: Compared with the stable weight group (-5 ~ 5%), those with weight loss ≥10% had a higher risk of CVD (hazard ratio (HR) = 1.21; 95% confidence interval (CI) = 1.05-1.40) in the fully adjusted model. Weight gain >10% was significantly associated with a higher risk of CVD (HR = 1.17; 95% CI = 1.04-1.31). In the meanwhile, participants with weight loss ≥10% had significantly higher risks of stroke (HR = 1.20; 95% CI = 1.02-1.41). However, participants with weight gain >10% had an increased risk of MI (HR = 1.45; 95% CI = 1.15-1.82) in the fully adjusted model.

Conclusions: Weight loss or weight gain were associated with higher risks of CVD. Management of patients with hypertension requires close monitoring and appropriate interventions to achieve optimal body weight to prevent adverse outcomes.