What question did this study set out to answer?

To characterize continuous, age-related trajectories of blood pressure and pulse pressure stratified by sex and body mass index categories to improve cardiovascular risk assessment.

March 26, 2026Hypertension ResearchOpen Access

Sex-specific trajectories of blood pressure and pulse pressure across body mass index categories: a descriptive study based on 13-year health checkup data

Q: What are the key findings of this study?

Higher body mass index was associated with accelerated age-related increases in systolic blood pressure and an earlier peak in diastolic blood pressure, which occurred at 51.0 years in men with class 2 obesity compared to 58.6 years in normal-weight men.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Hypertension and blood pressure trajectories (n=213058). Intervention: Body mass index (BMI) categories vs. Normal weight and underweight categories. Primary outcome: Age-related trajectories of systolic blood pressure, diastolic blood pressure, pulse pressure, and heart rate.

Q: What does this research mean for the field?

Higher body mass index is associated with accelerated age-related increases in systolic blood pressure and an earlier peak in diastolic blood pressure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Higher BMI is linked to accelerated age-related SBP increases and an earlier DBP peak.

n=213,058

Why the study?

The combined effects of aging, sex, and body mass index on blood pressure trajectories remain incompletely characterized in large-scale populations.

Population

213058 individuals undergoing annual physical examinations at Kagoshima Kouseiren Hospital in 2007-2019

Comparison

Trajectories stratified by sex and BMI categories

Design

Retrospective observational study

Authors

SKShin KawasoePreventive Cardiology TKT KubozonoKagoshima University YAYuichi AkasakiPreventive Cardiology

Discussion

Member takes

Implication

May support earlier weight and BP management in obese adults; extends evidence linking BMI to accelerated vascular aging by sex.

Key Points

To characterize continuous, age-related trajectories of blood pressure and pulse pressure stratified by sex and body mass index categories to improve cardiovascular risk assessment.
Retrospectively analyzed annual health checkup records from 213,058 individuals (108,217 men and 104,841 women) examined between 2007 and 2019 at Kagoshima Kouseiren Hospital in Japan.
Stratified participants by sex and BMI categories: underweight (<18.5 kg/m²), normal weight (18.5–24.9 kg/m²), class 1 obesity (25.0–29.9 kg/m²), and class 2 obesity or higher (≥30.0 kg/m²).
Modeled age-related changes in systolic blood pressure, diastolic blood pressure, pulse pressure, and resting heart rate across adulthood using locally weighted scatterplot smoothing (LOWESS).
Systolic blood pressure rose continuously across age in both sexes, while diastolic blood pressure followed a biphasic curve that peaked in midlife and declined thereafter, widening pulse pressure most rapidly in men with obesity.
Hypertension prevalence increased with age across all BMI categories; in participants with class 2 obesity or higher, prevalence surpassed 80% by age 60–64 and reached over 90% by age 75–79 in men, while approaching 90% in the oldest women.
Resting heart rate remained stable across adulthood before rising after age 70 years, consistently displaying higher baseline values in women and in participants with obesity across all age brackets.

Study Design

Type

Observational (n=213,058)

Multicenter

Structured PICO

Population

Individuals who underwent annual physical examinations at Kagoshima Kouseiren Hospital in 2007–2019

Outcome

Age-related trajectories of systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure, and heart ratesurrogate

Distinct age-related blood pressure and pulse pressure changes vary by sex and BMI, with obesity accelerating vascular aging and widening pulse pressure earlier in life.

Limitations

Findings may not be generalizable beyond Japanese populations as the dataset was derived from a single health checkup facility.
Within-individual correlations were not explicitly accounted for in the LOWESS analysis.
The descriptive, non-parametric technique does not allow adjustment for potential confounders.
Cross-sectional design limits the ability to make causal inferences.
Unmeasured lifestyle factors such as diet, stress, and medication adherence were not available.
Heart rate was derived from a single resting ECG, which may be influenced by transient arrhythmias.
Age of data acquisition is different for each individual within an age category and tends to be biased toward data from earlier age periods within a category
LOWESS method does not explicitly account for within-individual correlations
Generated curves represent population-level smoothed trends rather than subject-level longitudinal changes

Cite This Study

Kawasoe et al. (2026) conducted an observational in Hypertension and blood pressure trajectories (n=213,058). Body mass index (BMI) categories vs. Normal weight and underweight categories was evaluated on Age-related trajectories of systolic blood pressure, diastolic blood pressure, pulse pressure, and heart rate. Higher body mass index was associated with accelerated age-related increases in systolic blood pressure and an earlier peak in diastolic blood pressure, which occurred at 51.0 years in men with class 2 obesity compared to 58.6 years in normal-weight men.

synapsesocial.com/papers/69c4cd05fdc3bde448918d15 https://doi.org/10.1038/s41440-026-02607-7

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Sex-specific trajectories of blood pressure and pulse pressure across body mass index categories: a descriptive study based on 13-year health checkup data

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Sex-specific trajectories of blood pressure and pulse pressure across body mass index categories: a descriptive study based on 13-year health checkup data

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider