scholarly journals Association of Time–Varying Intensity of Ventilation With Mortality in Patients With COVID−19 ARDS: Secondary Analysis of the PRoVENT–COVID Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Michiel T. U. Schuijt ◽  
David M. P. van Meenen ◽  
Ignacio Martin–Loeches ◽  
Guido Mazzinari ◽  
Marcus J. Schultz ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Secondary Analysis ◽  
Fixed Time ◽  
Sensitivity Analyses ◽  
Cumulative Exposure ◽  
Time Varying ◽  
Joint Models ◽  
Clinical Trial Registration ◽  
Increased Risk ◽  
Different Levels

Background: High intensity of ventilation has an association with mortality in patients with acute respiratory failure. It is uncertain whether similar associations exist in patients with acute respiratory distress syndrome (ARDS) patients due to coronavirus disease 2019 (COVID−19). We investigated the association of exposure to different levels of driving pressure (ΔP) and mechanical power (MP) with mortality in these patients.Methods: PRoVENT–COVID is a national, retrospective observational study, performed at 22 ICUs in the Netherlands, including COVID−19 patients under invasive ventilation for ARDS. Dynamic ΔP and MP were calculated at fixed time points during the first 4 calendar days of ventilation. The primary endpoint was 28–day mortality. To assess the effects of time–varying exposure, Bayesian joint models adjusted for confounders were used.Results: Of 1,122 patients included in the PRoVENT–COVID study, 734 were eligible for this analysis. In the first 28 days, 29.2% of patients died. A significant increase in the hazard of death was found to be associated with each increment in ΔP (HR 1.04, 95% CrI 1.01–1.07) and in MP (HR 1.12, 95% CrI 1.01–1.36). In sensitivity analyses, cumulative exposure to higher levels of ΔP or MP resulted in increased risks for 28–day mortality.Conclusion: Cumulative exposure to higher intensities of ventilation in COVID−19 patients with ARDS have an association with increased risk of 28–day mortality. Limiting exposure to high ΔP or MP has the potential to improve survival in these patients.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04346342.

scholarly journals FRI0421 RATES OF PROGRESSION DIFFER BETWEEN STRUCTURAL PHENOTYPES OF KNEE OSTEOARTHRITIS: A SECONDARY ANALYSIS FROM THE FNIH COHORT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 808.1-809
Author(s):  
F. Roemer ◽  
J. Collins ◽  
T. Neogi ◽  
M. Crema ◽  
A. Guermazi
Keyword(s):  
Subchondral Bone ◽  
Radiographic Progression ◽  
Conditional Logistic Regression ◽  
Secondary Analysis ◽  
Sensitivity Analyses ◽  
Case Group ◽  
Composite Outcome ◽  
Bone Phenotype ◽  
Increased Risk ◽  
Inflammatory Phenotype

Background:Imaging plays an important role in determining structural disease severity and potential suitability of patients recruited to disease-modifying osteoarthritis drug (DMOAD) trials. It has been suggested that there may be three main structural phenotypes in OA, i.e., inflammation, meniscus/cartilage and subchondral bone. These may progress differently and may represent distinct tissue targets for DMOAD approaches.Objectives:To stratify the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium (FNIH) cohort, a well-defined subsample of the larger Osteoarthritis Initiative (OAI) study, into distinct structural phenotypes based on semiquantitative MRI assessment and to determine their risk for progression over 48 months.Methods:The FNIH was designed as a case-control study with knees showing either 1) radiographic and pain progression (i.e., “composite” cases), 2) radiographic progression only (“JSL”), 3) pain progression only, and 4) neither radiographic nor pain progression. MRI of both knees was performed on 3 T systems at the four OAI clinical sites. Two musculoskeletal radiologists read the baseline MRIs according to the MOAKS scoring system. Knees were stratified into subchondral bone, meniscus/cartilage and inflammatory phenotypes1. A secondary, less stringent definition for inflammatory and meniscus/cartilage phenotype was used for sensitivity analyses. The relation of each phenotype to risk of being in the JSL or composite case group compared to those not having that phenotype was determined using conditional logistic regression. Only KL2 and 3 and those without root tears were included.Results:485 knees were included. 362 (75%) did not have any phenotype, while 95 (20%) had the bone phenotype, 22 (5%) the cartilage/meniscus phenotype and 19 (4%) the inflammatory phenotype. The bone phenotype was associated with a higher risk of the JSL and composite outcome (OR 1.81;[95%CI 1.14,2.85] and 1.65; 95%CI [1.04,2.61]) while the inflammatory (OR 0.96 [95%CI 0.38,2.42] and 1.25; 95%CI [0.48,3.25]) and the meniscus/cartilage phenotypes were not (OR 1.30 95%CI [0.55,3.07] and 0.99; 95%CI [0.40,2,49]).In sensitivity analyses, the bone phenotype and having two phenotypes (vs. none) were both associated with increased risk of experiencing the composite outcome (bone: OR 1.65; 95% CI 1.04, 2.61; 2 phenotypes: OR 1.87; 95% CI 1.11, 3.16.Conclusion:The bone phenotype was associated with increased risk of having both radiographic and pain progression together, or radiographic progression alone, whereas the inflammatory phenotype or meniscus/cartilage phenotype each individually were not associated with either outcome. Phenotypic stratification appears to provide insights into risk for structural or composite structure plus pain progression, and therefore may be useful to consider when selecting patients for inclusion in clinical trials.References:[1]Roemer FW, Collins J, Kwoh CK, et al. MRI-based screening for structural definition of eligibility in clinical DMOAD trials: Rapid OsteoArthritis MRI Eligibility Score (ROAMES). Osteoarthritis Cartilage 2020;28(1):71-81Disclosure of Interests:Frank Roemer: None declared, Jamie Collins Consultant of: Boston Imaging Core Lab (BICL), LLC., Tuhina Neogi Grant/research support from: Pfizer/Lilly, Consultant of: Pfizer/Lilly, EMD-Merck Serono, Novartis, Michel Crema: None declared, Ali Guermazi Consultant of: AventisGalapagos, Pfizer, Roche, AstraZeneca, Merck Serono, and TissuGene

scholarly journals Real-world Evidence of Time-varying Effects of Renin-angiotensin System Inhibitors on Pneumonia and Related Deaths: A Territory-wide Cohort Study in 252,616 Patients With Diabetes (2002-2019)

2021 ◽  
Author(s):  
Aimin Yang ◽  
Mai Shi ◽  
Hongjiang Wu ◽  
Eric SH Lau ◽  
Baoqi Fan ◽  
...  
Keyword(s):  
Renin Angiotensin System ◽  
Chinese Patients ◽  
Cumulative Exposure ◽  
Time Varying ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Reduced Risk

Abstract BackgroundDiabetes is associated with increased risk of respiratory infections. Renin-angiotensin system (RAS) inhibition with anti-fibrotic, anti-inflammatory effects may reduce pneumonia risk. Prior studies did not account for time-varying and cumulative exposure to RAS inhibitors (RASi), with short follow-up periods, nor compared angiotensin converting enzyme inhibitor (ACEi) and angiotensin receptor blocker (ARB) use in Asians. We investigated the association of long-term use of RASi with risk of pneumonia and related death in Chinese people with diabetes using electronic medical record (EMR) data.MethodsThis was a prospective analysis of EMR with overlap propensity-score weighting of a territory-wide cohort (n=252,616, 1.7 million person-years) and a register-based cohort (n=13,017, 0.1 million person-years) in Hong Kong. We compared new-users of RASi (ACEi/ARBs) following baseline assessment with non-RASi users and new-users of calcium-channel blockers as active comparator. The main outcome was first hospitalization and death from pneumonia. ResultsAmongst 252,616 patients with diabetes in the population-based cohort (mean age=61.0 [SD=12.2] years), 73,161 were new-ACEi-only users; 20,907 new-ARBs-only users; 38,778 ACEi/ARBs users; and 119,770 never-ACEi/ARBs users. Over a mean follow-up period of 6.7 years, 5.2% (n=13,057) of patients had pneumonia and 2.2% (n=5,480) died with pneumonia. Compared with non-RASi use, time-varying RASi exposure was associated with reduced risk of pneumonia (hazard ratio, HR, 95% CI): 0.78 (0.75-0.82) and pneumonia-related death (HR=0.49, 0.46-0.53). The respective HRs for ARBs-only were 0.70 (0.62-0.78) and 0.41 (0.33-0.52) and that of ACEi-only were 0.98 (0.91-1.05) and 0.77 (0.68-86). In the Aalen-additive hazards model, the effect of RASi use was time-invariant for pneumonia (P=0.340) and time-varying for related death (P<0.001) with prevention of 0.6 (0.2-0.9) and 1.4 (1.0-1.6) per-1000-person-years pneumonia events and related deaths, respectively.ConclusionsLong-term use of RASi, notably ARB, was associated with reduced risk of pneumonia and related deaths in Chinese patients with diabetes.

Abstract MP06: Statins and the Risk of Diabetes Type II in Children Ages 8 to 20 with and without Dyslipidemia

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Nina Joyce ◽  
Justin Zachariah ◽  
Charles Eaton ◽  
Amal trivedi ◽  
Gregory Wellenius
Keyword(s):  
Latency Period ◽  
Type Ii Diabetes Mellitus ◽  
Sensitivity Analyses ◽  
Cumulative Exposure ◽  
Type Ii ◽  
Eligibility Criteria ◽  
Match Rate ◽  
Increased Risk ◽  
Significant Difference ◽  
Statin Use

Introduction: There is increasing evidence of a causal association between statin use and type II diabetes mellitus (T2DM) in adults. However the risk of incident T2DM in children treated with statins is unknown, and a recent study demonstrating a protective effect of familial hypercholesterolemia suggests there may be heterogeneity of effect by the presence of genetic dyslipdemia. We estimated the association between statin use and the risk of T2DM in a commercially insured population ages 8 to 20 from 2004 to 2013 with and without a diagnosis of dyslipidemia. Methods: New users of statins with a minimum 75 percent of days covered (PDC) in the first year of use were matched to up to 10 non-users using year-specific propensity scores within a 0.01 caliper. The outcome was defined as incident T2DM more than 12 months after the match date to address possible confounding by indication and allow for a biologically plausible level of cumulative exposure. Cox proportional hazard models were used to estimate the relative hazards for T2DM among statin users and non-users. Time was defined from the end of the 12 month latency period to either the outcome or censoring. Sensitivity analyses varied the width of this exclusionary window, as well as PDC to test the robustness of our results to study assumptions. Results: There were a total of 13,443,478 patients who met eligibility criteria, 755 (0.1%) of whom were started on statins and met the minimum PDC. Of these, 748 (98%) were matched with no significant difference in the year-specific match rate. Statin use was associated with an increased risk of T2DM in children without dyslipidemia diagnosis (HR 2.75, 95%CI 1.20-6.30, p=0.01), but not in children with a recorded diagnosis of dyslipidemia (HR 1.01, 95%CI 0.59-1.70, p=0.98). The results were robust to variations in the latency period and PDC (figure). Conclusion: Statin use was associated with increased risk of new onset T2DM in children without a dyslipidemia diagnosis, but not in children with a diagnosis of dyslipidemia.

Abstract P377: Oral Estrogen Hormone Therapy Use after Incident Venous Thrombosis and the Risk of Recurrence

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Laura B Harrington ◽  
Kerri L Wiggins ◽  
Marc Blondon ◽  
James S Floyd ◽  
Joshua C Bis ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Hormone Therapy ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Time Varying ◽  
Oral Estrogen ◽  
Diabetes Status ◽  
Increased Risk ◽  
Time Varying Covariates

Background: Oral estrogen hormone therapy (HT) is associated with a 2-fold increased risk of incident venous thrombosis (VT). Patterns of HT use following an incident VT and the association between HT use and recurrence are poorly characterized. Objectives: We aimed: (1) to characterize the use of oral estrogen HT in the 5 months following a first VT event; and (2) to evaluate whether the use of HT following an incident VT is associated with VT recurrence. Methods: In Group Health Cooperative (GHC), an integrated health care system, we identified an inception cohort of women aged 40-89 who experienced an incident VT from 2002 to 2010 (n=1,121). Using medical record review, we followed participants for VT recurrence, defined by physician diagnosis >2 weeks after the incident VT with clinical and/or imaging evidence of a new or expanded clot. HT use at 80% compliance was defined using GHC computerized pharmacy data. Characterization of HT use was restricted to women who survived for ≥5 months. Cox proportional hazards models were used to evaluate the association between time-varying current HT use and risk of recurrent VT, adjusting for race, baseline age, BMI, idiopathic incident VT, diabetes status, and the following time-varying covariates: cancer, CVD, and current anticoagulation use. In primary analyses, time was defined as days since incident event and censoring occurred at last follow-up or death. To evaluate the influence of possible HT misclassification soon after the incident event, we conducted 2 sensitivity analyses in which women entered the risk set after 30 and 60 days post-incident VT. Additional secondary Cox analyses were restricted to current HT users at the time of incident VT. Results: Of women who survived ≥5 months post-incident VT (n=993), 12% used oral estrogen HT at time of the incident event (n=123); among these, 90 (73%) discontinued use whereas 33 (27%) continued to fill ≥1 HT prescription within the next 5 months. Compared with users who stopped HT, persistent users were on average older (70 vs. 65 years), had a lower BMI (29 vs. 32 kg/m 2 ), and were less likely to have experienced an incident PE as part of their first VT event (27% vs. 61%). Over an average follow-up of 3.4 years, we identified 164 recurrent VTs among 1,121 women. We found no evidence of an association between HT use after incident VT and VT recurrence risk, adjusted for confounders (HR=0.73; 95% CI: 0.26-1.99; p=0.53); no evidence of an association was found in sensitivity or secondary analyses. Conclusions: In this population of GHC enrollees, over one-quarter of oral estrogen HT users at VT incidence continued use and filled subsequent HT prescriptions in the 5 months following the incident event. We found no evidence of an association between post-event HT use and the risk of VT recurrence, however, the number of HT users in our population was small.

scholarly journals Exposure-weighted scoring for metabolic syndrome and the risk of myocardial infarction and stroke: a nationwide population-based study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Eun Young Lee ◽  
Kyungdo Han ◽  
Da Hye Kim ◽  
Yong-Moon Park ◽  
Hyuk-Sang Kwon ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Sensitivity Analyses ◽  
Cumulative Exposure ◽  
Cumulative Number ◽  
Mets Component ◽  
Increased Risk ◽  
Score Range

Abstract Background Metabolic syndrome (MetS) status changes over time, but few studies have investigated the relationship between the extent or duration of exposure to MetS and the risk of cardiovascular disease (CVD). We investigated the cumulative effects of MetS and its components on the risk of myocardial infarction (MI) and stroke. Methods From the Korean National Health Insurance database, 2,644,851 people who received annual health examinations from 2010 to 2013 were recruited. Exposure-weighted scores for MetS during this 4-year period were calculated in two ways: cumulative number of MetS diagnoses (MetS exposure score, range: 0–4) and the composite of its five components (MetS component exposure score, range: 0–20). The multivariable Cox proportional-hazards model was used to assess CVD risk according to the exposure-weighted scores for MetS. Results MetS was identified at least once in 37.6% and persistent MetS in 8.2% of subjects. During the follow-up (median, 4.4 years), 10,522 cases of MI (0.4%) and 10,524 cases of stoke (0.4%) occurred. The risk of MI and stroke increased gradually with increasing exposure scores of MetS and its components (each P for trend < 0.0001). The hazard ratio [(HR) (95% CI)] of MI and stroke were 5.27 (4.20–6.62) and 3.90 (3.09–4.93), respectively, in those with a score of 20 compared with those with a MetS component exposure score of 0. People fulfilling only two MetS components out of 20 already had 22% increased risk of MI, and those with three MetS components had 24% increased risk of stroke. These associations were consistent in the subgroup and sensitivity analyses. Conclusions A dose–response relationship between the cumulative exposure to metabolic disturbances and incident MI or stroke was evident. Even minimal exposure to MetS components was sufficient to increase the risk of CVD significantly, highlighting the importance of intensive risk management for the prevention of CVD.

The cost implication of primary prevention in the HOPE 3 trial

2019 ◽  
Vol 5 (3) ◽  
pp. 266-271
Author(s):  
Andre Lamy ◽  
Eva Lonn ◽  
Wesley Tong ◽  
Balakumar Swaminathan ◽  
Hyejung Jung ◽  
...  
Keyword(s):  
Developing Countries ◽  
Primary Prevention ◽  
Cost Saving ◽  
Developed Countries ◽  
Sensitivity Analyses ◽  
Clinical Trial Registration ◽  
Pressure Lowering ◽  
The Cost ◽  
Care Costs ◽  
Country Specific

Abstract Aims The Heart Outcomes Prevention Evaluation-3 (HOPE-3) found that rosuvastatin alone or with candesartan and hydrochlorothiazide (HCT) (in a subgroup with hypertension) significantly lowered cardiovascular events compared with placebo in 12 705 individuals from 21 countries at intermediate risk and without cardiovascular disease. We assessed the costs implications of implementation in primary prevention in countries at different economic levels. Methods and results Hospitalizations, procedures, study and non-study medications were documented. We applied country-specific costs to the healthcare resources consumed for each patient. We calculated the average cost per patient in US dollars for the duration of the study (5.6 years). Sensitivity analyses were also performed with cheapest equivalent substitutes. The combination of rosuvastatin with candesartan/HCT reduced total costs and was a cost-saving strategy in United States, Canada, Europe, and Australia. In contrast, the treatments were more expensive in developing countries even when cheapest equivalent substitutes were used. After adjustment for gross domestic product (GDP), the costs of cheapest equivalent substitutes in proportion to the health care costs were higher in developing countries in comparison to developed countries. Conclusion Rosuvastatin and candesartan/HCT in primary prevention is a cost-saving approach in developed countries, but not in developing countries as both drugs and their cheapest equivalent substitutes are relatively more expensive despite adjustment by GDP. Reductions in costs of these drugs in developing countries are essential to make statins and blood pressure lowering drugs affordable and ensure their use. Clinical trial registration HOPE-3 ClinicalTrials.gov number, NCT00468923.

A model to account for the consequences of host nutrition on the outcome of gastrointestinal parasitism in sheep: model evaluation

Parasitology ◽  
2007 ◽  
Vol 134 (9) ◽  
pp. 1279-1289 ◽  
Author(s):  
D. VAGENAS ◽  
S. C. BISHOP ◽  
I. KYRIAZAKIS
Keyword(s):  
Mathematical Model ◽  
Worm Burden ◽  
Management Strategies ◽  
Sensitivity Analyses ◽  
Sheep Model ◽  
Host Nutrition ◽  
Gastrointestinal Parasitism ◽  
Different Characteristics ◽  
Nutritional Strategies ◽  
Different Levels

SUMMARYThis paper describes sensitivity analyses and expectations obtained from a mathematical model developed to account for the effects of host nutrition on the consequences of gastrointestinal parasitism in sheep. The scenarios explored included different levels of parasitic challenge at different planes of nutrition, for hosts differing only in their characteristics for growth. The model was able to predict the consequences of host nutrition on the outcome of parasitism, in terms of worm burden, number of eggs excreted per gram faeces and animal performance. The model outputs predict that conclusions on the ability of hosts of different characteristics for growth to cope with parasitism (i.e. resistance) depend on the plane of nutrition. Furthermore, differences in the growth rate of sheep, on their own, are not sufficient to account for differences in the observed resistance of animals. The model forms the basis for evaluating the consequences of differing management strategies and environments, such as breeding for certain traits associated with resistance and nutritional strategies, on the consequences of gastrointestinal parasitism on sheep.

Pre-Existing Psychiatric Illness Is Associated With an Increased Risk of Delirium in Patients With Acute Respiratory Distress Syndrome

2021 ◽  
pp. 088506662110190
Author(s):  
Saminder Singh Kalra ◽  
Johnny Jaber ◽  
Bashar N. Alzghoul ◽  
Ryan Hyde ◽  
Sarina Parikh ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Psychiatric Illness ◽  
Distress Syndrome ◽  
Multivariable Logistic Regression Analysis ◽  
Psychiatric Illnesses ◽  
Increased Risk ◽  
Icu Delirium ◽  
The Impact

Background: Patients with acute respiratory distress syndrome (ARDS) are highly susceptible to developing delirium for a multitude of reasons. Previous studies have linked pre-existing depression with an increased risk of postoperative delirium in patients undergoing cardiac and non-cardiac surgery. However, the evidence regarding the association between pre-existing psychiatric illnesses and delirium in ARDS patients is unknown. In this study, we aim to determine the relationship between pre-existing psychiatric illness and the risk of development of delirium amongst ARDS patients. Study Design and Methods: We performed a retrospective study of a mixed group of patients admitted to the intensive care unit (ICU) between January 2016 and December 2019 with a diagnosis of ARDS per the Berlin definition. The study group was divided into 2 cohorts: subjects with delirium and subjects without delirium. Comparison between the 2 groups was conducted to examine the impact of pre-existing psychiatric illnesses including major depressive disorder (MDD), generalized anxiety disorder (GAD), bipolar disorder, schizophrenia, or post-traumatic stress disorder. Multivariable logistic regression analysis was performed adjusting for benzodiazepine use, sedatives, analgesics, sequential organ failure assessment score, and corticosteroid use to determine the association between pre-existing psychiatric disorders and delirium. Results: 286 patients with ARDS were identified; 124 (43%) of whom were diagnosed with ICU delirium. In patients diagnosed with ICU delirium, 49.2% were found to have preexisting psychiatric illnesses, compared to 34.0% without any preexisting psychiatric illness (OR = 1.94, P = 0.01). In a subgroup analysis of individual psychiatric illnesses, GAD and MDD were associated with the development of delirium (OR = 1.88, P = 0.04 and OR = 1.76, P = 0.05 respectively). Interpretation: ARDS patients with preexisting psychiatric illnesses, particularly GAD and MDD are associated with an increased risk of developing ICU delirium. Clinicians should be aware of the effect of psychiatric co-morbidities on developing delirium in critically ill patients.

Body mass index and risk of all-cause mortality in normotensive and hypertensive adults: The Rural Chinese Cohort Study

2021 ◽  
pp. 1-25
Author(s):  
Qionggui Zhou ◽  
Xuejiao Liu ◽  
Yang Zhao ◽  
Pei Qin ◽  
Yongcheng Ren ◽  
...  
Keyword(s):  
Cohort Study ◽  
Population Based ◽  
Normal Weight ◽  
Sensitivity Analyses ◽  
Hypertension Status ◽  
Moderation Effect ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Chinese Cohort ◽  
The Impact

Abstract Objective: The impact of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to examine the moderation effect of hypertension on the BMI–mortality association using a rural Chinese cohort. Design: In this cohort study, we investigated the incident of mortality according to different BMI categories by hypertension status. Setting: Longitudinal population-based cohort Participants: 17,262 adults ≥18 years were recruited from July to August of 2013 and July to August of 2014 from a rural area in China. Results: During a median 6-year follow-up, we recorded 1109 deaths (610 with and 499 without hypertension). In adjusted models, as compared with BMI 22-24 kg/m2, with BMI ≤18, 18-20, 20-22, 24-26, 26-28, 28-30 and >30 kg/m2, the HRs (95% CI) for mortality in normotensive participants were 1.92 (1.23-3.00), 1.44 (1.01-2.05), 1.14 (0.82-1.58), 0.96 (0.70-1.31), 0.96 (0.65-1.43), 1.32 (0.81-2.14), and 1.32 (0.74-2.35) respectively, and in hypertensive participants were 1.85 (1.08-3.17), 1.67 (1.17-2.39), 1.29 (0.95-1.75), 1.20 (0.91-1.58), 1.10 (0.83-1.46), 1.10 (0.80-1.52), and 0.61 (0.40-0.94) respectively. The risk of mortality was lower in individuals with hypertension with overweight or obesity versus normal weight, especially in older hypertensives (≥60 years old). Sensitivity analyses gave consistent results for both normotensive and hypertensive participants. Conclusions: Low BMI was significantly associated with increased risk of all-cause mortality regardless of hypertension status in rural Chinese adults, but high BMI decreased the mortality risk among individuals with hypertension, especially in older hypertensives.

Sign in / Sign up

Export Citation Format

Share Document