Relationship between body mass index and pulse pressure in a non-diabetic population: evidence from a multicenter,...

Growing evidence shows that pulse pressure (PP) is a strong risk factor for cardiovascular disease and is closely associated with cardiovascular events, strokes, and mortality. However, currently, data on the relationship between body mass index (BMI) and PP are still limited.

Here, a cross-sectional study was conducted based on 211,809 non-diabetic adults in 11 cities in China from 2010 to 2016. Raw data were obtained from a public database (www.datadryad.org). According to the BMI level, they are classified into "underweight", "normal", "overweight", and "obesity" groups. Two groups of continuous variables were measured by the Mann-Whitney test, while the differences between multiple groups were tested by Kruskal-Wallis' One-Way ANOVA and Dunn's test. Besides, multiple linear regression analyses were performed to assess the linear relationship between BMI and PP. In addition, multivariate logistic regression was carried out to further confirm the relationship between different BMI levels and the prevalence of high PP.

In the total population, BMI was linearly positively related to PP regardless of gender and age, but it was not observed in the elevated blood pressure group. Multiple linear regression analysis showed that after fully adjusting for the maximum covariates, compared to the normal group, PP in the overall population decreased by 2.19 mmHg in the underweight group and increased by 1.426 and 2.919 mmHg in the overweight and obese groups, respectively. Similar results were observed in men, women, age <60 years, and normotensive groups. However, there was no significantly linear relationship between BMI and PP at the age of ≥60 years and elevated blood pressure groups. Besides, from multiple logistic regression analysis, the similar results were obtained, with no obvious association between BMI and high PP prevalence in those aged ≥60 years or with elevated blood pressure.

PP increased with rising BMI in the overall population. However, stratified analysis demonstrated no significant association between BMI and PP in individuals aged over 60 years or with elevated blood pressure.