Key result
Severe abdominal obesity with moderately elevated SBP is linked to ~161% higher stroke risk.
Why the study?
Abdominal obesity and elevated systolic blood pressure are established stroke risk factors, but their joint longitudinal patterns and combined associations with stroke incidence remain unclear.
Are joint trajectories of abdominal obesity and systolic blood pressure associated with incident stroke in aging populations?
Cohort (n=9,997)
Yes
Are joint trajectories of abdominal obesity and systolic blood pressure associated with incident stroke in aging populations?
Severe abdominal obesity confers a high risk of incident stroke even without markedly elevated blood pressure, suggesting additive associations between abdominal adiposity and systolic blood pressure.
Answers are grounded in this paper and cite their sources.
May warrant monitoring combined obesity-BP trajectories; extends additive risk data but leaves causal effects open for trials.
BACKGROUND: Abdominal obesity and elevated systolic blood pressure (SBP) are established stroke risk factors, yet their joint longitudinal patterns and combined associations on stroke incidence remain unclear. We aimed to identify joint trajectory groups of waist-to-height ratio (WHtR) and SBP and evaluate their associations with incident stroke. METHODS: We included 5,128 participants from the Health and Retirement Study (HRS, United States, 2006-2018) and 4,869 from the English Longitudinal Study of Ageing (ELSA, England, 2004-2012). Group-based multi-trajectory modeling jointly classified WHtR and SBP trajectories. Cox regression with progressive covariate adjustment estimated hazard ratios (HRs) for incident stroke. Subgroup and sensitivity analyses were performed. RESULTS: Four joint WHtR-SBP trajectory groups were identified in both cohorts. Compared with the "Non-abdominal obesity & Normal SBP" reference group, the group characterized by the highest WHtR yet only moderately elevated SBP had the greatest stroke risk in both the HRS (HR = 2.61, 95%CI 1.85-3.67) and ELSA (HR = 2.34, 95%CI 1.34-4.10), followed by the group with abdominal obesity and high SBP (HRS: HR = 2.49; ELSA: HR = 2.03). Joint exposure analysis confirmed additive associations, with co-occurring exposures conferring the greatest risk (HRS: HR = 2.68; ELSA: HR = 2.53). Associations were stronger among participants without hypertension. CONCLUSIONS: Abdominal obesity and elevated SBP show additive associations on incident stroke through distinct joint trajectory patterns, consistently replicated across two independent cohorts. Severe abdominal obesity conferred the highest stroke risk even without markedly elevated blood pressure, suggesting that longitudinal monitoring of abdominal adiposity alongside blood pressure management may improve stroke risk stratification in aging populations.
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Luo et al. (2026) conducted a cohort in Incident stroke (n=9,997). Joint trajectories of waist-to-height ratio (WHtR) and systolic blood pressure (SBP) vs. Non-abdominal obesity & Normal SBP was evaluated on Incident stroke (HR 2.61, 95% CI 1.85-3.67). Severe abdominal obesity with moderately elevated systolic blood pressure conferred the highest risk of incident stroke compared to normal parameters (HRS: HR 2.61, 95% CI 1.85-3.67; ELSA: HR 2.34).
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