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

Objective: 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. Methods: This dynamic cohort study included 24104 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. Results: 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). Conclusion: 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 prioritizing age-specific approaches to weight management for hypertension prevention and control.