Association Between Lifestyle Behaviors and Body Mass Index with Blood Pressure Classifications Among Older Adults with Hypertension in China

Jian Wu¹Yue Chen¹Yudong Miao¹Quanman Li¹Clifford Silver Tarimo^1,2Nengguang Dai³Qiuping Zhao⁴Yadong Niu^1*

• ¹Department of Health management, College of Public Health, Zhengzhou University, Zhengzhou, China
• ²Department of Science and Laboratory Technology, Dar es salaam Institute of Technology, Dar es Salaam, Tanzania
• ³Grassroots Health and Health Department, Health Commission of Henan Province, Zhengzhou, China
• ⁴Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, China

Objective: This study aimed to examine the association between lifestyle behaviors and body mass index (BMI) along with their potential interactions with the severity of blood pressure (BP) classifications among older adults with hypertension.Methods: Among 17,441 participants, lifestyle behaviors were assessed, including smoking, drinking, dietary patterns, physical activity, and sleeping. Multinomial logistic regression was used to examine the association between lifestyle behaviors and BMI with BP classifications, and multiplicative interactions were included to estimate potential interactions. To explore variations, analyses were also stratified by BMI.Results: High-risk dietary pattern and obesity were negatively associated with lower BP classifications, with odds ratios (ORs) and 95% confidence intervals (CIs) for normal BP, highnormal BP, and grade 1 hypertension in high-risk dietary pattern were 0.74 (0.57 to 0.95), 0.69 (0.54 to 0.90), 0.75 (0.59 to 0.95), and the ORs (95% CIs) in obesity were 0.61 (0.53 to 0.69), 0.77 (0.67 to 0.89), 0.82 (0.73 to 0.93). Compared with never drinking, former drinkers had higher odds of having normal BP (OR:1.45, 95% CI:1.15 to 1.82), high-normal BP (OR:1.31, 95% CI:1.02 to 1.67), and grade 1 hypertension (OR:1.26, 95% CI:1.01 to 1.58). The multiplicative interaction between drinking status and BMI was found on BP classifications (P for interaction <0.05), and the effects of former drinking and low PA level on BP control were significant in overweight and underweight groups, respectively (P<0.05).Poor diet and obesity are associate with severe BP, particularly among non-drinking older adults, suggesting targeted interventions in rural primary care.