A groundbreaking study published in The Lancet has found that many obese adults now have cholesterol and blood pressure levels indistinguishable from those of healthy-weight individuals, and in some cases, are even better off. Researchers attribute this shift to the widespread use of cholesterol-lowering statins and blood pressure medications, which are more frequently prescribed to people with obesity.
Study Details and Findings
The research analyzed data from nearly one million adults aged 20 to 79 across England, Japan, South Korea, Taiwan, Thailand, Finland, and the United States. Scientists reviewed 110 health surveys from 1990 to 2024, examining blood pressure, cholesterol, and body mass index (BMI) figures, along with prescription records for cholesterol-lowering and antihypertensive drugs.
Results showed that problematic cholesterol and blood pressure levels declined over time, especially among those aged 40 and older. These reductions were more pronounced in individuals with obesity, leading to a convergence of these risk factors between obese and normal-BMI groups in older adults. In England, the USA, Thailand, South Korea, and Japan, older people with obesity often became indistinguishable from, or better off than, those with normal BMI in terms of non-HDL cholesterol and systolic blood pressure.
Expert Commentary
Professor Majid Ezzati, from Imperial College London's School of Public Health, said: "Our study suggests that, in high-income countries, taking medication to lower blood pressure and cholesterol has helped middle-age and older adults lower their cardiovascular risk to levels that are similar to people with normal BMI." He added that the findings provide a picture of cardiovascular health for those likely to be prescribed weight-loss medications, which have surged in popularity.
Lakshya Jain, also from Imperial College, noted: "This latest analysis suggests that the observed convergence in cholesterol and blood pressure levels between people aged over 40 with obesity and those with a normal BMI is largely due to statins and other widely accessible medications to reduce cardiovascular risk. That is a significant public health success story."
Caveats and Younger Adults
However, researchers caution that the benefits do not extend to younger adults. Among those under 40, individuals with obesity still showed elevated harmful cholesterol and raised blood pressure. Study author Yse d'Ailhaud de Brisis commented: "While good news for older adults with obesity, our results suggest that cardiovascular health risks remain higher for adults under 40 than for their counterparts with a normal BMI. Early lifestyle interventions, screening and, when appropriate, medication in this younger group should be considered."
Professor Edward Gregg emphasized that the findings "don't mean that obesity does not still increase your risk of other outcomes," such as diabetes, kidney disease, and some cancers.
Public Health Implications
Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation, stated: "This study highlights a powerful public health success story – it shows just how effective modern treatments for blood pressure and cholesterol have become. But we must not lose sight of the bigger picture. These medications are needed because of the adverse effects of obesity on cardiovascular disease risk."
The research underscores the importance of continued use of statins and antihypertensives, even as new weight-loss drugs enter the market, to maintain cardiovascular health gains.
