体质量指数的变化与不同职业类型人群高血压的关联性OA

[Background]With rising obesity rates and earlier hypertension onset among occupational pop-ulations,there is an urgent need to elucidate the long-term cardiovascular impacts of dynamic body weight patterns.Current evidence lacks trajectory modeling studies examining occupation-specific prevention strategies. [Objective]To investigate the association between long-term body mass index(BMI)trajectories and incident hypertension risk in Chinese working adults,and to examine occupation-specific heterogeneity in this relationship. [Methods]A dynamic sub-cohort of 4 413 occupational participants was constructed from ten survey waves(1991-2018)of the China Health and Nutrition Survey(CHNS).Eligible individuals had valid key BMI records at three or more independent follow-ups before the outcome event;the individual baseline was set as the year of their first participation in the survey.Group-based trajectory modeling(GBTM)was used to identify BMI change patterns.Cox proportional hazards regression was used to calculate hazard ratios(HRs)and 95%confidence interval(CI)for hypertension incidence across trajectory groups,with stratified analysis by occupational categories. [Results]Among 4 413 occupational participants,1 441 incident hypertension cases were reported during the follow-up window.Three long-term BMI trajectories were identified:low-stable,moderate-slowly rising,and high-rising.In Model 3 with all selected confounders adjusted,compared with the low-stable group,the moderate-slowly rising group showed a significantly higher risk of incident hypertension(HR=1.28,95%CI:1.12,1.45;P<0.001),as did the high-increasing group(HR=1.80,95%CI:1.45,2.23;P<0.001).The stratified analyses revealed occupational differences in the association.Among agricultural workers,the moderate-slowly rising group(HR=1.35,95%CI:1.15,1.57)and the high-rising group(HR=2.00,95%CI:1.50,2.66)both exhibited significantly increased risks of hypertension(P<0.001).Conversely,among white-collar workers,an increased risk of hypertension was observed only in the high-rising group(HR=1.97,95%CI:1.23,3.17;P<0.05). [Conclusion]Rapid BMI escalation constitutes a significant risk factor for incident hypertension in occupational populations.Targeted long-term weight monitoring and tailored interventions are recommended for high-risk occupations.