Body Weight Fluctuations and the Risk for Future Hypertension Among Normotensive Middle‐Aged Adults

Background: Data on the association between body weight fluctuations and the risk of future hypertension in apparently healthy adults is limited and conflicting. The aim of the present study was to examine whether temporal change in body weight can be used to predict the development of hypertension in normotensive middle‐aged adults.

Methods: We investigated 7,798 normotensive subjects who were annually screened at the ambulatory service of Sheba medical center, Israel, and had ≥5 consecutive visits. Clinical data, including body weight and blood pressure, were collected at each visit. After the initial 4 visits, subjects were divided into two groups based on the standard deviation of their four baseline BMI values. The primary end point was new onset hypertension during follow-up.

Results: Mean age of the study population was 47±10 years and 70% were men. Average baseline resting blood pressure was 117/75±18/13 mmHg. During a mean follow‐up of 11±3 years, 918 (12%) subjects developed hypertension. Cox regression landmark analysis with adjustment for age, gender and baseline systolic blood pressure showed that subjects with high BMI fluctuations were 29% more likely to develop hypertension during follow-up compared with subjects with low BMI fluctuations. (95% CI 1.08-1.56, P=0.006). In contrast, a Time dependent analysis of up to 15 consecutive visits with further adjustment to clinical parameters failed to show an association between BMI fluctuation during follow up and a risk for the development of hypertension (p=.437). Nevertheless, the same model showed that each 1 Kg/m² increment in BMI during follow up was independently associated with respective 8% increased risk for the development of hypertension (95% CI 1.04-1.23, P<.001).

Conclusions: In normotensive middle‐aged individuals, temporal body weight gain, but not temporal body weight fluctuations, is independently associated with future development of hypertension.