Association of Body Mass Index with Hypertension in Patients with Healthy Weight

Abstract

Objective: To determine the association between body mass index (BMI) and hypertension in the healthy weight group (BMI: >18.5-<25.0) stratified by age, sex, and race. Methods: Patient age, sex, race, BMI, and a diagnosis of hypertension for 51,435 adult patients (>18 years old) seen since 2015 at either the family medicine clinic or general internal medicine clinics were obtained from the electronic health record using ICD-10 codes for hypertension. This analysis was implemented on the 14,443 of these patients whose BMI values were between 18.5 and <25. Logistic regression was used to assess the relationship between BMI and hypertension with and without adjusting for the impact of age, race, and sex. Odds ratios were calculated for both the adjusted and unadjusted models. Results: Hypertension rates for healthy weight individuals steadily increased with BMI and age, which were independently associated with hypertension. The percentage of patients with hypertension by race was 20.9%, 18.1%, 13.1%, 11.7%, and 9.5% for Black, White, Asian, Other, and Hispanic/Latino, respectively. Fewer women had hypertension compared with men (15.5% vs 20.4%). Tests of odds ratios (both adjusted and unadjusted) indicated that individuals with greater BMI measurements in the healthy weight group are at significantly greater risk for hypertension. Conclusions: Patients in the healthy weight group with higher BMI within that group are at greater risk for hypertension. Patients who are male, Black, or older are also at greater risk of hypertension relative to the rest of the patient population.