Association of changes in body weight and waist circumference with a subsequent risk of developing hypertension in men requiring specific healthcare guidance

Although body weight (BW) and waist circumference (WC) reduction are key goals of Japan's Specific Health Guidance program, limited evidence exists linking these reductions to a lower incidence of hypertension. This study aimed to evaluate the association between changes in BW and WC and the subsequent development of hypertension among men in a nationwide population. We retrospectively analyzed 23,109 men aged 40-64 years who required intensive health guidance and had no prior history of hypertension, using a nationwide database (DeSC Healthcare, Tokyo, Japan) from April 2014 to August 2023. One-year changes in BW and WC were examined for their association with incident hypertension using multivariable Cox regression and cubic spline analyses. During a mean follow-up of 1381 ± 789 days, 4162 men (18.0%) developed hypertension. Greater reductions in BW and WC were associated with a progressively lower risk of hypertension. In multivariable Cox models, BW reductions of ≤ -3.0 kg, -2.9 to -2.0 kg, and -1.9 to -1.0 kg were significantly associated with reduced hypertension risk (HR: 0.74 [95% CI: 0.67-0.82], 0.85 [0.76-0.96], and 0.89 [0.81-0.99], respectively). WC reductions of ≤ -3.0 cm and -2.9 to -2.0 cm were also significantly associated with reduced risk (HR: 0.80 [0.73-0.88] and 0.81 [0.72-0.92], respectively). Cubic spline analyses confirmed a monotonic decrease in hypertension risk with increasing BW and WC reduction. Among men eligible for Specific Health Guidance, one-year reductions in BW and WC were significantly associated with a lower risk of developing hypertension.