Coexisting hypertension and obesity (prevalence 18.0-37.3%) was consistently associated with the highest risk of incident heart failure across multiple adiposity definitions.
Cohort (n=455,213)
Yes
Does the coexistence of hypertension and obesity increase the risk of incident heart failure compared to either condition alone or neither?
The coexistence of hypertension and obesity synergistically increases the risk of incident heart failure, highlighting the importance of managing both risk factors even at preclinical stages.
BACKGROUND: This study examined the association of hypertension and obesity with incident heart failure (HF) and the feasibility of the clinical obesity definition proposed by The Lancet Diabetes & Endocrinology Commission. METHODS: Data from the UK Biobank (n = 444,754) and Tongzhou Cohort (n = 10,459) were analyzed. Hypertension was defined as physician-diagnosed hypertension, blood pressure ≥140/90 mmHg, or antihypertensive treatment. Obesity was assessed as BMI-defined obesity, central obesity, a combined "BMI+central" anthropometric phenotype, and clinical obesity, defined as excess adiposity with obesity-related organ dysfunction and/or functional limitation. Participants were classified into four groups: neither hypertension nor obesity, obesity only, hypertension only, and coexisting hypertension and obesity. Kaplan-Meier curves and multivariable Cox models were used to estimate HF risk, and joint effects of elevated blood pressure and pre-obesity were evaluated. RESULTS: The two cohorts had similar mean ages: 58.15 ± 6.84 years in the UK Biobank and 59.42 ± 6.29 years in Tongzhou Cohort. Depending on the obesity definition, the prevalence of coexisting hypertension and obesity ranged from 18.0% to 25.9% in the UK Biobank and 23.1% to 37.3% in Tongzhou Cohort. Across BMI-defined obesity, central obesity, the combined "BMI+central" phenotype, and, in the UK Biobank, clinical obesity, coexistence of hypertension and obesity was consistently associated with the highest HF risk. Among individuals without hypertension or obesity, the combination of elevated blood pressure and pre-obesity was associated with increased risk of HF. CONCLUSION: Coexisting hypertension and obesity are associated with the highest HF risk across multiple adiposity definitions, and excess risk is evident even at preclinical stages.
Du et al. (Thu,) conducted a cohort in Hypertension and Obesity (n=455,213). Coexisting hypertension and obesity vs. Neither hypertension nor obesity was evaluated on Incident heart failure. Coexisting hypertension and obesity (prevalence 18.0-37.3%) was consistently associated with the highest risk of incident heart failure across multiple adiposity definitions.