Association between changes in body mass index and hypertension among different occupational groups

Zhongting LU; Lili CHEN; Hongru JIANG; Lixin HAO; Liusen WANG; Weiyi LI; Yu WU; Huijun WANG; Bing ZHANG; Jiguo ZHANG; Zhihong WANG

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Association between changes in body mass index and hypertension among different occupational groups

VernacularTitle:体质量指数的变化与不同职业类型人群高血压的关联性
Author: Zhongting LU ¹ ; Lili CHEN ¹ ; Hongru JIANG ¹ ; Lixin HAO ¹ ; Liusen WANG ¹ ; Weiyi LI ¹ ; Yu WU ¹ ; Huijun WANG ¹ ; Bing ZHANG ¹ ; Jiguo ZHANG ¹ ; Zhihong WANG ¹
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1. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China;NHC Key Laboratory of Public Nutrition and Health, Beijing 100050, China.
Publication Type:Specialcolumn:Dietarynutritionandhealthforworkingpopulations
Keywords: body mass index; hypertension; occupational group; trajectory analysis; China Health and Nutrition Survey
From: Journal of Environmental and Occupational Medicine 2026;43(2):168-173
CountryChina
Language:Chinese
Abstract: Background With rising obesity rates and earlier hypertension onset among occupational populations, there is an urgent need to elucidate the long-term cardiovascular impacts of dynamic body weight patterns. Current evidence lacks trajectory modeling studies examining occupation-specific prevention strategies. Objective To investigate the association between long-term body mass index (BMI) trajectories and incident hypertension risk in Chinese working adults, and to examine occupation-specific heterogeneity in this relationship. Methods A dynamic sub-cohort of 4 413 occupational participants was constructed from ten survey waves (1991–2018) of the China Health and Nutrition Survey (CHNS). Eligible individuals had valid key BMI records at three or more independent follow-ups before the outcome event; the individual baseline was set as the year of their first participation in the survey. Group-based trajectory modeling (GBTM) was used to identify BMI change patterns. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence interval (CI) for hypertension incidence across trajectory groups, with stratified analysis by occupational categories. Results Among 4413 occupational participants, 1441 incident hypertension cases were reported during the follow-up window. Three long-term BMI trajectories were identified: low-stable, moderate-slowly rising, and high-rising. In Model 3 with all selected confounders adjusted, compared with the low-stable group, the moderate-slowly rising group showed a significantly higher risk of incident hypertension (HR=1.28, 95%CI: 1.12, 1.45; P < 0.001), as did the high-increasing group (HR=1.80, 95%CI: 1.45, 2.23; P < 0.001). The stratified analyses revealed occupational differences in the association. Among agricultural workers, the moderate-slowly rising group (HR=1.35, 95%CI: 1.15, 1.57) and the high-rising group (HR=2.00, 95%CI: 1.50, 2.66) both exhibited significantly increased risks of hypertension (P<0.001). Conversely, among white-collar workers, an increased risk of hypertension was observed only in the high-rising group (HR=1.97, 95%CI: 1.23, 3.17; P<0.05). Conclusion Rapid BMI escalation constitutes a significant risk factor for incident hypertension in occupational populations. Targeted long-term weight monitoring and tailored interventions are recommended for high-risk occupations.