Life stage-specific heterogeneity in the effects of adiposity transition on hypertension incidence and resolution

Whether the effects of excess adiposity on the onset and resolution of hypertension and its subtypes differ across different life stages remains unclear. We aimed to explore age-related heterogeneity in the associations of excess adiposity transition with hypertension development and resolution over the life course in Chinese population.

This dynamic cohort study included 24,104 participants aged 3 to 80 years from the China Health and Nutrition Survey. We calculated the odd ratios (ORs) and confidence intervals (CIs) of excess adiposity at baseline and adiposity status transition during follow-up associated with hypertension using generalized linear mix-effects model.

High body mass index (BMI) at baseline showed the strongest association with hypertension incidence in early adulthood (OR 2.29, 95% CI 2.14-2.45), while high waist circumference (WC) showed the strongest association in childhood (OR 3.14, 95% CI 1.75-5.20). Participants transitioning from normal to high BMI/WC had increased hypertension incidence risks across all age groups, with the strongest association observed in the 3-17 year group (BMI, OR = 2.08, 95% CI = 1.42-2.96; WC, OR = 3.41, 95% CI = 2.26-4.97). In comparison, participants transitioning from high BMI/WC to normal BMI/WC had the strongest association in the 3-17 year group for BMI (OR = 4.73, 95% CI = 0.50-57.5) and in the 18-40 year group for WC (OR = 2.52, 95% CI = 1.48-4.44).

This study demonstrated life stage-specific heterogeneity in the effects of excess adiposity on hypertension, with individuals in childhood and early life conferring stronger influences. These results underscore the importance of considering age-specific approaches to weight management for hypertension prevention and control.