For decades, it's been assumed that adults living with obesity are more likely to suffer from high blood pressure and unhealthy cholesterol levels. But a groundbreaking study published in The Lancet has revealed a surprising trend: among those over 40, the differences between people with obesity and those with a healthy body mass index (BMI) have "narrowed or disappeared". This significant finding is largely attributed to the widespread use of cholesterol-lowering drugs, such as statins, and blood pressure medications.
Using data from nearly one million adults aged 20 to 79 across several countries, including England, researchers from Imperial College London analysed health surveys conducted between 1990 and 2024. Their results show that while individuals with obesity were historically more prone to elevated blood pressure and higher levels of unhealthy cholesterol, this disparity has largely disappeared among middle-aged and older adults.
Professor Majid Ezzati from the School of Public Health at Imperial College London highlights the impact of medication on cardiovascular health: "Our study suggests that taking medication to lower blood pressure and cholesterol in high-income countries has helped middle-age and older adults reduce their cardiovascular risk to levels similar to those with a normal BMI." He notes that these findings are crucial for understanding the cardiovascular health profile of individuals who may be prescribed newer weight-loss medications, which are gaining popularity.
While the news is positive for older adults, the study also reveals a concerning picture for younger demographics. Adults under 40 living with obesity still demonstrated higher levels of unhealthy cholesterol and elevated blood pressure. Yse d'Ailhaud de Brisis from Imperial College London stresses that "good news for older adults with obesity doesn't mean younger adults are off the hook" – and that continued lifestyle interventions, screening, and medication may be needed to mitigate long-term cardiovascular complications.
The study's findings build upon existing research by providing a contemporary snapshot of cardiovascular health in an era of increased pharmacological intervention. While experts welcome the effectiveness of current treatments, they caution against assuming obesity no longer poses significant health risks – particularly for younger adults.