Body Mass Index and Risk of Incident Hypertension over the Life Course: The Johns Hopkins Precursors Study
Background—The obesity-hypertension link over the life course has not been well characterized although the prevalence of obesity and hypertension are increasing in the United States.
Methods and Results—We studied the association of body mass index (BMI) in young adulthood, into middle age, and through late life with risk of developing hypertension in 1132 white men of The Johns Hopkins Precursors Study, a prospective, cohort study. Over a median follow-up period of 46 years, 508 men developed hypertension. Obesity (BMI ≥ 30 kg/m2) in young adulthood was strongly associated with incident hypertension (hazard ratio (HR) = 4.17, 95% CI (2.34-7.42)). Overweight (BMI 25 to < 30 kg/m2) also signaled increased risk (HR = 1.58, 95% CI (1.28-1.96)). Men of normal weight at age 25 years who became overweight or obese at age 45 were at increased risk compared to men of normal weight at both times (HR = 1.57, 95% CI (1.20-2.07)), but not men who were overweight or obese at age 25 years who returned to normal weight at age 45 years (HR = 0.91, 95% CI (0.43-1.92)). After adjusting for time-dependent number of cigarettes smoked, cups of coffee taken, alcohol intake, physical activity, parental premature hypertension and baseline BMI, the rate of change in BMI over the life course, increased the risk of incident hypertension in a dose-response fashion, with the highest risk among men with the greatest increase in BMI (HR = 2.52, 95% CI (1.82-3.49)).
Conclusions—Our findings underscore the importance of higher weight and weight gain in increasing the risk of hypertension from young adulthood, through middle age, and into late life.
- Received May 8, 2012.
- Accepted November 6, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited