What is the clinical evidence from this study?

Study design: Cohort. Population: Stroke (n=66048). Intervention: Obesity vs. Normal weight. Primary outcome: Stroke.

What question did this study set out to answer?

This study aimed to assess the independent contribution of obesity to stroke risk among 50-year-olds in Northern Sweden.

May 8, 2026Open Access

Abstract Number: Esoc2026a2011 the Association Between Obesity and Stroke Risk Among 50-Year-Olds in Northern Sweden, a Prospective Cohort Study

Key Result

Obesity was not independently associated with an increased risk of stroke within 15 years among 50-year-olds, whereas hypertension (HR 1.98; 95% CI 1.75-2.24) significantly increased stroke risk.

Key Points

This study aimed to assess the independent contribution of obesity to stroke risk among 50-year-olds in Northern Sweden.
Retrospective register study using data from health examinations, stroke register, and patient register.
Included individuals aged 48-52 years from 1985-2022 with observable body mass index data.
Follow-up duration was 15 years, employing descriptive analyses and Cox regression analyses using SPSS.
Of 66,048 patients, 1,251 (1.9%) suffered a stroke over 15 years.
Hypertension and diabetes were more common in obese individuals compared to those with normal weight.
Hypertension (HR 1.98; 95% CI 1.75-2.24) and diabetes (HR 1.67; 95% CI 1.31-2.14) were linked to increased stroke risk, while obesity was not.

Study Design

Type

Cohort (n=66,048)

Structured PICO

Does obesity increase the risk of stroke within 15 years among 50-year-olds?

Population

66,048 individuals aged 48-52 years old from Northern Sweden who participated in health examinations between 1985-2022 and had available body mass index data.

Intervention

Obesity

Comparator

Normal weight

Outcome

Stroke within 15 yearshard clinical

Obesity is not independently associated with 15-year stroke risk in 50-year-olds, but it indirectly increases risk by driving higher prevalences of hypertension and diabetes.

Abstract

Abstract Background and aims The prevalence of obesity is increasing worldwide, yet among metabolically healthy individuals the independent contribution of obesity to stroke risk is disputed. This study aimed to determine the stroke risk attributable to obesity among 50-year-olds. Methods This retrospective register study was conducted using data from the Northern Sweden Health and Disease Study, the Swedish stroke register, and the National Patient Register. Individuals who participated in health examinations between 1985-2022 and aged 48-52 years old were included, while patients lacking data on body mass index were excluded. Follow-up time was 15 years. Descriptive analyses and Cox regression analyses of the relationships between comorbidities and stroke risk were performed using SPSS. Results 66,048 patients were included, of whom 13537 (20.6%) had hypertension, 11646 (17.6%) were obese, and 1251 (1.9%) suffered a stroke within 15 years. Hypertension and diabetes were less prevalent in patients with normal weight (respectively 12.0% and 0.6%) compared to obesity (respectively 37.4% and 4.1%). Hypertension (HR 1.98; 95% CI 1.75-2.24), male sex (HR 1.89; 95% CI 1.67-2.13), smoking (HR 1.85; 95% CI 1.62-2.11) and diabetes (HR 1.67; 95% CI 1.31-2.14) were associated with an increased stroke risk, while obesity and total cholesterol levels were not. Conclusions While obesity was not independently associated with an increased risk of stroke within 15 years among 50-year-olds, it was associated with a higher prevalence of hypertension and diabetes, which in turn were associated with an increased risk of stroke. Hence, hypertension and diabetes, together with smoking cessation, represent focus points for stroke preventive interventions. Conflict of interest David Darehed: nothing to disclose. Sonja Palm: nothing to disclose. Marie Eriksson: nothing to disclose. Eva-Lotta Glader: nothing to disclose.