Dr Bazzano had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Body mass index and risk of stroke among Chinese men and women
Article first published online: 23 DEC 2009
Copyright © 2010 American Neurological Association
Annals of Neurology
Volume 67, Issue 1, pages 11–20, January 2010
How to Cite
Bazzano, L. A., Gu, D., Whelton, M. R., Wu, X., Chen, C.-S., Duan, X., Chen, J., Chen, J.-C. and He, J. (2010), Body mass index and risk of stroke among Chinese men and women. Ann Neurol., 67: 11–20. doi: 10.1002/ana.21950
- Issue published online: 23 FEB 2010
- Article first published online: 23 DEC 2009
- Accepted manuscript online: 23 DEC 2009 12:00AM EST
- Manuscript Accepted: 7 DEC 2009
- Manuscript Revised: 1 DEC 2009
- Manuscript Received: 24 MAY 2009
- American Heart Association, Dallas, TX. Grant Number: National grant-in-aid 9750612N
- National Heart, Lung, and Blood Institute of the NIH, Bethesda, MD. Grant Number: V01 HL072507
- Chinese Ministry of Health, Beijing, China. Grant Number: 1999-272
- Chinese Academy of Medical Sciences, Beijing, China
- National Center for Research Resources of the NIH, Bethesda, MD via the Tulane Hypertension and Renal Center of Excellence. Grant Number: P20-RR017659
The relationship between body mass index (BMI) and stroke incidence and mortality remains controversial, particularly in Asian populations.
We conducted a prospective cohort study in a nationally representative sample of 169,871 Chinese men and women age 40 years or older. Data on body weight was obtained at baseline examination in 1991 using a standard protocol. Follow-up evaluation was conducted in 1999 to 2000, with a response rate of 93.4%.
After excluding those participants with missing body weight or height values, 154,736 adults were included in the analysis. During a mean follow-up of 8.3 years, 7,489 strokes occurred (3,924 fatal). After adjustment for age, gender, physical inactivity, urbanization, geographic variation, cigarette smoking, diabetes, and education, compared with participants of normal weight (BMI 18.5–24.9), relative hazard (95% confidence interval) of incident stroke was 0.86 (0.80–0.93) for participants who were underweight (BMI < 18.5), 1.43 (1.36–1.52) for those who were overweight (BMI 25–29.9), and 1.72 (1.55–1.91) for those who were obese (BMI ≥ 30). The corresponding relative hazards were 0.76 (0.66–0.86), 1.60 (1.48–1.72), and 1.89 (1.66–2.16) for ischemic stroke and 1.00 (0.89–1.13), 1.18 (1.06–1.31), and 1.54 (1.27–1.87) for hemorrhagic stroke. For stroke mortality, the corresponding relative hazards were 0.94 (0.86–1.03), 1.15 (1.05–1.25), and 1.47 (1.26–1.72). Linear trends were significant for all outcomes (p < 0.0001).
These results suggest that elevated BMI increases the risk of both ischemic and hemorrhagic stroke incidence, and stroke mortality in Chinese adults. ANN NEUROL 2010;67:11–20