Increases in Weight and Body Size Increase the Odds for Hypertension During 7 Years of Follow‐up

Abstract

Changes in BMI and body size were compared to incident hypertension in 24,550 men and 10,111 women followed prospectively as part of the National Runners’ Health Study to test whether long-term weight change affects hypertension risk. Incident hypertensions were reported by 2,143 men and 430 women during (mean ± s.d.) 7.8 ± 1.8 and 7.5 ± 2.0 years of follow-up, respectively. Despite being active, men’s and women’s BMI increased 1.15 ± 1.70 and 0.95 ± 1.89 kg/m2, respectively, and their waist circumferences increased 2.97 ± 5.02 and 3.29 ± 6.67cm, respectively. Compared to those whose BMI declined, those who gained ≥2.4kg/m2 had an odds ratio (95% confidence interval) of 1.68 (1.45, 1.94) for becoming hypertensive if male and 1.42 (1.05, 1.92) if female. Men whose waist circumference increased ≥ 6cm had an odds ratio of 1.22 (1.01, 1.47) for becoming hypertensive compared to those whose waists decreased. In both sexes, the odds for hypertension were significantly related to BMI at follow-up when adjusted for baseline BMI, but generally not to baseline BMI when adjusted for follow-up BMI. In the subset whose weights remained relatively unchanged during follow-up (±0.4kg/m2), each kg/m2 increment in average BMI was associated with an odds ratio for becoming hypertensive of 1.19 (1.14, 1.24) in men and 1.11 (1.02, 1.20) in women. Thus, even among lean, physically active individuals: (i) weight gain increases hypertension risk; (ii) higher body weight increases the hypertension risk in a dose-dependent manner in the absence of any weight change; and (iii) there is no advantage carried forward to having been previously lean.

Long-term stable obesity increases risk of hypertension

“…Recently, Shuger et al 6 clearly showed that women with a BMI X24.7 kg/m 2 had a risk of developing hypertension that was over two times higher than women with a BMI of 18.5-20.0 kg/m 2 . On the other hand, some recent prospective cohort studies [13][14][15][16][17][18][19] reported that long-term weight gain increases the risk for hypertension. Those studies [13][14][15][16][17][18][19] showed that the risk for incident hypertension in subjects whose BMI increased during a follow-up period was significantly greater compared with subjects who maintained or decreased BMI.…”

Role of Body Mass Index History in Predicting Risk of the Development of Hypertension in Japanese Individuals

“…[1][2][3][4][5][6][7][8][9][10] Also, it has been noted that weight gain increases the risk of hypertension, 1,2,7,[11][12][13][14][15][16][17] whereas weight loss contributes to a reduction in risk. [18][19][20] However, it has not been fully clarified whether overall adiposity in early adulthood such as around age 20 years or at the lifetime maximum would irreversibly confer a residual risk of hypertension after considering the risk associated with current adiposity.…”

Differences in weight gain in hypertensive and diabetic elderly patients primary care study

“…Other studies reported that higher body weight increased the risk of hypertension in a dosedependent manner, and there was no advantage of having been previously lean [19]. Weight gain was associated with an increased risk of pre-diabetic condition, greater in those who were not overweight in childhood [20].…”