Response to Letter Regarding Article, “Does Body Mass Index Impact on the Relationship Between Systolic Blood Pressure and Cardiovascular Disease? Meta-Analysis of 419 488 Individuals From the Asia Pacific Cohort Studies Collaboration”
We were pleased to read that Drs Lin, Jaiteh, and Han1 read our article2 with great interest. However, we fail to see how our work could provide any real evidence for the postulated lower death rate in obese populations with established vascular disease. Our article suggests that blood pressure has slightly less effect on cardiovascular disease with increasing body mass index, which says nothing about how obesity acts after an adverse vascular event.
We hope that readers of this Letter will not associate our article with this hypothesis, the exploration of which requires other data. Even if the occasional findings of “reverse epidemiology,” cited by Lin et al, are not purely attributable to chance, one would have to know about longitudinal changes in risk factors and disease to understand the underlying etiology and, thus, draw any clinical implications.
Finally, in answer to the final point of Lin et al, a study of the effects of body mass index on the relationship between blood pressure and secondary cardiovascular disease is planned within another collaboration managed by the George Institute for Global Health, the Blood Pressure Lowering Treatment Trialists' Collaboration.3
on behalf of the Asia Pacific Cohort Studies Collaboration
The George Institute
University of Sydney
Sydney, New South Wales, Australia
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- © 2012 American Heart Association, Inc.
- Lin GM,
- Jaiteh LES,
- Han CL
- Tsukinoki R,
- Murakami Y,
- Huxley R,
- Ohkubo T,
- Fang X,
- Suh I,
- et al