Medications for cholesterol and blood pressure are helping obese middle-aged and older adults maintain levels comparable to those of healthy-weight individuals, according to a recent study. Researchers found that blood pressure and cholesterol levels in adults over 40 with obesity were "indistinguishable" from their leaner counterparts, and in some instances, better.
These findings, published in The Lancet, are largely attributed to the widespread use of cholesterol-lowering drugs like statins and antihypertensive medications, which are more commonly prescribed to individuals with obesity. The study analyzed data from nearly one million adults aged 20 to 79 across seven high-income countries, including the United States, between 1990 and 2024.
Historically, individuals with obesity were more likely to experience elevated blood pressure and unhealthy cholesterol levels. However, the new research indicates that these disparities have significantly diminished or vanished for those aged 40 and above. Statins, introduced widely in the UK in the late 1990s, are now used by approximately eight million adults there.
Researchers emphasized the importance of these findings, especially as weight-loss medications gain popularity. Professor Majid Ezzati of Imperial College London stated that the study provides insight into the cardiovascular health of individuals likely to receive these new treatments, allowing healthcare systems to understand the combined benefits of weight-loss medications and existing treatments for blood pressure and cholesterol.
The analysis revealed that unhealthy cholesterol and blood pressure levels have declined over time, particularly in adults over 40. These declines were more pronounced among individuals with obesity, leading to a convergence of these risk factors. The study noted that differences in non-HDL cholesterol and systolic blood pressure between those with obesity and those with a normal body mass index (BMI) narrowed or disappeared, especially in older adults.
However, the researchers cautioned that this does not negate other health risks associated with obesity. Professor Edward Gregg of Imperial College London stressed that obesity can still increase the risk of other health outcomes. For adults under 40, the study found that obesity was still associated with higher levels of unhealthy cholesterol and blood pressure.
Author Yse d'Ailhaud de Brisis from Imperial College London suggested that cardiovascular health risks remain higher for younger adults with obesity compared to their normal-weight peers. The study recommends considering early lifestyle interventions, screening, and appropriate medication for this younger demographic to prevent long-term cardiovascular complications.
Lakshya Jain from Imperial College London described the convergence of cholesterol and blood pressure levels in older adults with obesity as a "significant public health success story," largely due to statins and other accessible medications for reducing cardiovascular risk. He urged that this success should not be overlooked as new weight-loss medications become more prevalent.
Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation, commented that the study demonstrates the effectiveness of modern treatments for blood pressure and cholesterol. He highlighted the achievement of many individuals over 40 with obesity reaching healthy weight-equivalent levels for these markers, attributing it to effective prevention strategies and medication adherence. However, he reiterated that these medications are necessary due to the adverse effects of obesity and that reducing obesity would offer broader health benefits, potentially lessening the need for such medications.