New research published in The Lancet indicates that individuals over 40 with obesity now exhibit blood pressure and cholesterol levels comparable to their peers with a normal body mass index (BMI). This convergence is attributed to the increased use of statins and blood pressure medications during the study period.

The study, which tracked cardiovascular risk factors for 25 years from 1990 to 2024, found a decline in blood pressure and unhealthy cholesterol levels among people aged 40 to 79 with overweight or obesity compared to those in the same age group with normal BMI. By 2024, adults in their 60s and 70s with obesity had blood pressure and unhealthy cholesterol levels that were similar to or even lower than older adults with normal BMI. However, for adults under 40, no such convergence in blood pressure and cholesterol levels was observed across different BMI groups.

Blood pressure drugs and statins became more widely used by middle-aged individuals with obesity over the study's duration. In the oldest age cohort, between 70% and 72% of adults with overweight or obesity were taking blood pressure drugs or statins. In contrast, 40% to 48% of adults in the same age group with normal BMI were utilizing these medications. Young adults under 40 had a low rate of receiving cholesterol or blood pressure medication, regardless of their BMI.

Yuan Lu, a Yale University researcher, commented that these findings should not suggest that obesity has become benign. Lu stated that the findings indicate that some cardiovascular consequences of obesity are increasingly being reduced through medical management. Majid Ezzati, professor of global environmental health at Imperial College London, added that the change in the character of obesity may be partly due to the higher use of antihypertensive and lipid-lowering medicines. Ezzati also stated that young adults have not experienced these metabolic benefits and remain at metabolic high risk.

Dan Jones, former president of the American Heart Association, emphasized the importance of understanding what the study both says and does not say. Jones stated that the key factor is whether these trends result in improved cardiovascular or kidney outcomes for patients. He further noted that diabetes and inflammation levels differ between obese and non-obese patients, which directly affects cardiovascular risk. The study, an observational analysis of blood pressure and cholesterol readings from 110 health datasets involving 1 million participants across seven countries, cannot establish cause and effect. Changes in blood pressure and cholesterol were less pronounced in Taiwan and Thailand.

Why It Matters

This research shows a shift in how cardiovascular risk factors manifest in older adults with obesity, suggesting that widespread medical interventions like statins and blood pressure medications are contributing to an equalization of these specific health indicators with those of normal-weight peers. This implies a large public health impact due to the sustained use of these affordable generic medications. The findings also draw attention to a potential disparity, as younger adults with obesity are not experiencing the same health benefits, indicating a need for different intervention strategies for this demographic.