Key result
Young adult obesity linked to up to ~15 mmHg higher SBP at age 45 vs normal weight.
Why the study?
It remained uncertain whether long-term body weight history across adulthood, rather than body weight at a single time point, is associated with later blood pressure trajectories.
Does body weight history (obesity or underweight) during young adulthood affect subsequent blood pressure trajectories compared to maintaining normal weight?
Cohort (n=406,814)
Does body weight history (obesity or underweight) during young adulthood affect subsequent blood pressure trajectories compared to maintaining normal weight?
Mean Difference: 15
p-value: p=<0.001
Long-term body weight history in young adulthood, including both obesity and underweight, is significantly associated with divergent blood pressure trajectories later in life, suggesting cumulative weight exposure is a key determinant of future hypertension risk.
Long-term weight history may refine BP trajectory risk stratification; leaves open whether it adds predictive value beyond single-timepoint BMI.
Background Whether long-term body weight history across adulthood, rather than body weight at a single time point, is associated with later blood pressure (BP) trajectories remains uncertain. We examined this association in a large longitudinal health checkup cohort. Methods We analyzed repeated systolic and diastolic blood pressure measurements from 406,814 participants in a Japanese employment-based health-check cohort using sex-stratified linear mixed-effects models with age-by-group interactions and adjustment for sleep, exercise habits, physical activity, and walking speed. Participants were classified into three groups: history of underweight (BMI < 18.5 kg/m² at least once; n = 80,890), normal weight only (BMI 18.5 to < 25.0 kg/m² throughout the 20s; n = 228,343), and history of obesity (BMI ≥ 25.0 kg/m² at least once; n = 97,581). Sensitivity analyses among 402,651 participants additionally adjusted for eating speed, breakfast skipping, and late-evening meals. The underweight-history and obesity-history groups were further subdivided by the proportion of follow-up time spent underweight or obese (0–25%, 25–50%, 50–75%, and 75–100%). Results Participants with a history of obesity during their 20s showed higher BP trajectories than those with normal weight only, and these differences increased with age. In contrast, participants with a history of underweight showed lower BP trajectories than the normal-weight-only group. Age-by-group interactions were significant in women and men for both systolic and diastolic BP (all P < 0.001). Additional adjustment for eating behaviors had minimal influence on these associations. In the nine-group analysis, the groups with 50–75% and 75–100% of follow-up time spent obese showed higher BP trajectories than the normal-weight-only group, whereas the groups with 50–75% and 75–100% of follow-up time spent underweight showed lower BP trajectories. Conclusions These findings suggest that shorter durations of obesity and underweight may be associated with BP trajectories closer to those of the normal-weight-only group. Overall, long-term body weight history may be more informative than body weight at a single time point when evaluating later BP burden.
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Katsumi Iizuka (2026) conducted a cohort in Blood pressure trajectories (n=406,814). History of obesity during 20s vs. Normal weight only throughout the 20s was evaluated on Systolic and diastolic blood pressure trajectories (MD +15.0 mmHg (SBP, women) and +8.8 mmHg (SBP, men) at age 45, p=<0.001). A history of obesity during young adulthood was associated with significantly higher blood pressure trajectories by age 45 compared to maintaining normal weight, with adjusted systolic blood pressure differences of +15.0 mmHg in women and +8.8 mmHg in men.
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