Introduction: Little is known regarding the joint associations of famine exposure and obesity patterns with the incidence of hypertension. Methods: We defined famine exposure cohorts as follows: nonexposure (born between 1962 and 1965), fetal life exposure (born between 1959 and 1961), early childhood exposure (born between 1956 and 1958), midchildhood exposure (born between 1953 and 1955), and late childhood exposure (born between 1949 and 1952). Obesity patterns were defined as follows: G−/A−: subjects without neither general obesity nor abdominal obesity; G+/A− or G−/A+: subjects with either general obesity or abdominal obesity; G+/A+: subjects with both general obesity and abdominal obesity. Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg or current treatment with antihypertensive medications. Results: There were 5,235 individuals participating in this study. In the subjects with general or abdominal obesity, famine exposure was associated with a lower risk of hypertension. In males with G−/A−, famine exposures in the midchildhood (p = 0.048; HR: 0.700; HR 95% CI: 0.491–0.998) and late childhood (p = 0.002; HR: 0.560; HR 95% CI: 0.374–0.840) were associated with a lower incidence of hypertension. Conclusion: The coexistence of famine exposure and obesity patterns was associated with the incidence of hypertension.

1.
Chuang
SY
,
Chou
P
,
Hsu
PF
,
Cheng
HM
,
Tsai
ST
,
Lin
IF
,
Presence and progression of abdominal obesity are predictors of future high blood pressure and hypertension
.
Am J Hypertens
.
2006 Aug
;
19
(
8
):
788
95
. .
2.
Mittal
BV
,
Singh
AK
.
Hypertension in the developing world: challenges and opportunities
.
Am J Kidney Dis
.
2010 Mar
;
55
(
3
):
590
8
. .
3.
Good
D
,
Morse
SA
,
Ventura
HO
,
Reisin
E
.
Obesity, hypertension, and the heart
.
J Cardiometab Syndr
.
2008
;
3
(
3
):
168
72
. .
4.
Georgianos
PI
,
Zebekakis
PE
.
General obesity, abdominal adiposity, and the risk of incident hypertension-From anthropometry to modern imaging techniques
.
J Clin Hypertens
.
2018 Oct
;
20
(
10
):
1427
9
. .
5.
Xi
B
,
Liang
Y
,
He
T
,
Reilly
KH
,
Hu
Y
,
Wang
Q
,
Secular trends in the prevalence of general and abdominal obesity among Chinese adults, 1993–2009
.
Obes Rev
.
2012 Mar
;
13
(
3
):
287
96
. .
6.
Nie
P
,
Ding
L
,
Sousa-Poza
A
.
Decomposing adult obesity trends in China (1991–2011)
.
Econ Hum Biol
.
2019 Aug
;
34
:
5
15
.
7.
Tomiyama
H
,
Matsumoto
C
,
Yamada
J
,
Yoshida
M
,
Odaira
M
,
Shiina
K
,
Predictors of progression from prehypertension to hypertension in Japanese men
.
Am J Hypertens
.
2009 Jun
;
22
(
6
):
630
6
. .
8.
Shen
Y
,
Chang
C
,
Zhang
J
,
Jiang
Y
,
Ni
B
,
Wang
Y
.
Prevalence and risk factors associated with hypertension and prehypertension in a working population at high altitude in China: a cross-sectional study
.
Environ Health Prev Med
.
2017 Apr 4
;
22
(
1
):
19
.
9.
Li
Y
,
Jaddoe
VW
,
Qi
L
,
He
Y
,
Lai
J
,
Wang
J
,
Exposure to the Chinese famine in early life and the risk of hypertension in adulthood
.
J Hypertens
.
2011
;
29
(
6
):
1085
92
. .
10.
Stanner
SA
,
Bulmer
K
,
Andrès
C
,
Lantseva
OE
,
Borodina
V
,
Poteen
VV
,
Does malnutrition in utero determine diabetes and coronary heart disease in adulthood? Results from the Leningrad siege study, a cross sectional study
.
BMJ
.
1997
;
315
(
7119
):
1342
8
.
11.
Stein
AD
,
Zybert
PA
,
van der Pal-de Bruin
K
,
Lumey
LH
.
Exposure to famine during gestation, size at birth, and blood pressure at age 59 year: evidence from the Dutch Famine
.
Eur J Epidemiol
.
2006
;
21
(
10
):
759
65
. .
12.
Nascimento-Ferreira
MV
,
De Moraes
AC
,
Rendo-Urteaga
T
,
de Oliveira Forkert
EC
,
Collese
TS
,
Cucato
GG
,
Cross-sectional, school-based study of 14–19 year olds showed that raised blood pressure was associated with obesity and abdominal obesity
.
Acta Paediatr
.
2017 Mar
;
106
(
3
):
489
96
. .
13.
Popkin
BM
,
Du
S
,
Zhai
F
,
Zhang
B
.
Cohort Profile: the China health and nutrition survey–monitoring and understanding socio-economic and health change in China, 1989–2011
.
Int J Epidemiol
.
2010 Dec
;
39
(
6
):
1435
40
.
14.
Sun
Y
,
Zhang
L
,
Duan
W
,
Meng
X
,
Jia
C
.
Association between famine exposure in early life and type 2 diabetes mellitus and hyperglycemia in adulthood: results from the China health and retirement longitudinal study (CHARLS)
.
J Diabetes
.
2018
;
10
(
9
):
724
33
. .
15.
Luo
Z
,
Mu
R
,
Zhang
X
.
Famine and overweight in China
.
Rev Agr Eco
.
2006
;
28
(
3
):
296
304
. .
16.
WHO Expert Consultation
.
Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies
.
Lancet
.
2004
;
363
(
9403
):
157
63
.
17.
Chobanian
AV
,
Bakris
GL
,
Black
HR
,
Cushman
WC
,
Green
LA
,
Izzo
JL
 Jr
,
Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure
.
Hypertension
.
2003 Dec
;
42
(
6
):
1206
52
. .
18.
Ke
L
,
Ho
J
,
Feng
J
,
Mpofu
E
,
Dibley
MJ
,
Li
Y
,
Prevalence, awareness, treatment and control of hypertension in Macau: results from a cross-sectional epidemiological study in Macau, China
.
Am J Hypertens
.
2015 Feb
;
28
(
2
):
159
65
.
19.
Roseboom
TJ
,
van der Meulen
JH
,
Ravelli
AC
,
Van Montfrans
GA
,
Osmond
C
,
Barker
DJ
,
Blood pressure in adults after prenatal exposure to famine
.
J Hypertens
.
1999
;
17
(
3
):
325
30
. .
20.
Li
C
,
Lumey
LH
.
Exposure to the Chinese famine of 1959–61 in early life and long-term health conditions: a systematic review and meta-analysis
.
Int J Epidemiol
.
2017 Aug 1
;
46
(
4
):
1157
70
. .
21.
Shi
Z
,
Nicholls
SJ
,
Taylor
AW
,
Magliano
DJ
,
Appleton
S
,
Zimmet
P
.
Early life exposure to Chinese famine modifies the association between hypertension and cardiovascular disease
.
J Hypertens
.
2018
;
36
(
1
):
54
60
. .
22.
Zhao
R
,
Duan
X
,
Wu
Y
,
Zhang
Q
,
Chen
Y
.
Association of exposure to Chinese famine in early life with the incidence of hypertension in adulthood: a 22-year cohort study
.
Nutr Metab Cardiovasc Dis
.
2019
;
29
(
11
):
1237
44
. .
23.
Wang
Z
,
Li
C
,
Yang
Z
,
Zou
Z
,
Ma
J
.
Infant exposure to Chinese famine increased the risk of hypertension in adulthood: results from the China health and retirement longitudinal study
.
BMC public health
.
2016 May 25
;
16
:
435
. .
24.
Mu
R
,
Zhang
X
.
Why does the Great Chinese famine affect the male and female survivors differently? Mortality selection versus son preference
.
Econ Hum Biol
.
2011 Jan
;
9
(
1
):
92
105
. .
25.
Zarulli
V
,
Barthold Jones
JA
,
Oksuzyan
A
,
Lindahl-Jacobsen
R
,
Christensen
K
,
Vaupel
JW
.
Women live longer than men even during severe famines and epidemics
.
Proc Natl Acad Sci USA
.
2018 Jan
;
115
(
4
):
E832
40
. .
26.
Vitale
C
,
Mendelsohn
ME
,
Rosano
GM
.
Gender differences in the cardiovascular effect of sex hormones
.
Nat Rev Cardiol
.
2009 Aug
;
6
(
8
):
532
42
. .
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.