Nutr Metab Cardiovasc Dis. 2026 Feb 5:104605. doi: 10.1016/j.numecd.2026.104605. Online ahead of print.
ABSTRACT
BACKGROUND AND AIM: Previous studies have typically measured waist circumference (WC) individually at baseline and are unlikely to accurately characterize the pattern of WC throughout the observation period. The long-term pattern of WC in hypertensive patients and its association with cardiovascular disease (CVD) events remains unclear. We aimed to investigate the association of WC trajectories with the risk of developing CVD in hypertensive patients.
METHODS AND RESULTS: Our data were drawn from the medical records of primary-care institutions in China. The present study included 72,601 individuals with hypertension attending primary healthcare centers. We used latent class trajectory analysis to group individuals with similar patterns of change in WC over time to understand the heterogeneity of CVD. Cox proportional-hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) between long-term WC trajectories (or WC in 2020) with CVD among hypertensive patients. We identified 4 distinct WC trajectories based on the measurement at baseline and changing patterns of WC between 2018 and 2020: low-stable, moderate-stable, moderate-high stable and high-stable. Compared with the low-stable trajectory group, the hazard ratios (HRs) for CVD were 1.08 (95% CI, 0.94-1.24) for the moderate-stable trajectory group, 1.24 (95% CI, 1.05-1.46) for the moderate-high stable trajectory group, and 1.33 (95% CI, 1.04-1.69) for the high-stable trajectory group after adjusting for all confounding variables, including baseline BMI. The association between WC trajectories and CVD risk did not materially change after excluding participants with BMI ≥28 kg/m2.
CONCLUSIONS: This cohort study of community-dwelling adults with hypertension demonstrates that long-term WC patterns were associated with altered risk of CVD, and elevated WC trajectories were associated with an increased risk of CVD.
PMID:41826192 | DOI:10.1016/j.numecd.2026.104605