Key Points
- To prospectively investigate the relationship between body mass index across the normal and overweight spectrum and the long-term risk of incident hypertension in initially healthy men.
- Prospective cohort study evaluating 13,563 healthy, nonhypertensive male participants from the Physicians' Health Study followed for a median duration of 14.5 years.
- Body mass index was calculated from self-reported baseline weight and height, while incident hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or new antihypertensive treatment.
- Over the median 14.5-year follow-up, 4,920 men developed hypertension, exhibiting a linear dose-response relationship across rising baseline body mass index quintiles (P for trend <.0001).
- Compared to the lowest quintile (<22.4 kg/m²), the relative risks (95% CI) of developing hypertension were 1.20 (1.09–1.32) for 22.4–23.6 kg/m², 1.31 (1.19–1.44) for 23.7–24.7 kg/m², 1.56 (1.42–1.72) for 24.8–26.4 kg/m², and 1.85 (1.69–2.03) for >26.4 kg/m².
- Associations persisted after adjusting for baseline blood pressure, diabetes, and hypercholesterolemia, as well as in sensitivity analyses excluding smokers and early incident cases.
Structured PICO
Does higher baseline BMI increase the risk of developing hypertension in initially healthy men?
PPopulation13,563 initially healthy, nonhypertensive men who participated in the Physicians' Health Study
IInterventionHigher baseline body mass index (BMI)
CComparatorLowest BMI quintile (<22.4 kg/m2)
OOutcomeIncident hypertension (self-reported systolic BP ≥ 140 mm Hg, diastolic BP ≥ 90 mm Hg, or new antihypertensive medication use)hard clinical
Higher baseline BMI, even within the normal and mildly overweight range, is strongly associated with an increased risk of developing hypertension in men.