SAN FRANCISCO, CA — Maintaining a healthy weight may be the most important factor in keeping blood pressure in check over the long haul, a new study suggests[1].

"The main finding in our study is that maintaining a healthy body weight into middle age may limit increases in blood pressure and help to preserve low blood pressure across the life-span," Dr John Booth III (University of Alabama, Birmingham) told | Medscape Cardiology.

"Since there are many factors that contribute to low blood-pressure levels and low body weight, having higher numbers of healthy behaviors is important for heart health overall, including healthy body weight, never smoking, no or moderate alcohol intake, physical activity, and eating a healthy diet," Booth said.

The study was presented at the 2017 American Heart Association (AHA) Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions.

For this analysis, they assessed 4630 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study, who were 18 to 30 years old in 1985 and 1986, when the study began. During the 25-year follow-up, participants had their blood pressure measured and health behaviors assessed eight times, until around middle age.

The researchers analyzed the impact of maintaining five health behaviors on blood-pressure levels over the course of 25 years: healthy body weight, defined as a body mass index less than 25 kg/m2; never smoking; consuming no more than seven alcoholic drinks weekly for women and no more than 14 for men; getting 150 minutes or more of moderate to vigorous physical activity per week; and eating a healthy diet, based on adhering to the Dietary Approaches to Stop Hypertension (DASH) eating plan.

Participants who maintained a healthy body weight were more likely to have normal blood pressure as they grew older. Specifically, those who maintained optimal body weight were 41% less likely to have an increasing blood pressure as they aged, Booth reported.

Maintaining physical activity or a healthy diet were not associated with changes in blood pressure during follow-up. Never smoking and maintaining no or moderate alcohol consumption were associated with less of an increase in blood pressure by middle age, but a larger study is needed to verify the connection, he noted.

Participants in the study who maintained at least four health behaviors were 27% more likely to have normal blood pressure than an increasing blood pressure from early adulthood through middle age (odds ratio 0.73, 95% CI 0.39–1.38).

Two-for-One Deal

"Maintaining as many healthy behaviors including a healthy body weight, never smoking, no or moderate alcohol intake, physical activity, and eating a healthy diet are important," Booth said. "Prior reports show higher numbers of healthy behaviors to be associated with better heart health. Our work extends prior studies by showing evidence that maintaining a normal body weight may be the most important factor" for keeping blood pressure in check.

"Patients and physicians should have an open dialogue about healthy behaviors and other factors contributing to heart health," he advised.

Commenting on the study for | Medscape Cardiology was AHA spokesperson Dr Willie Lawrence Jr (Midwest Heart & Vascular Specialists, Kansas City, MO).

"We know that there are different risk characteristics for hypertension and other heart ailments, and this study tries to tease out the importance of body weight and some of the other risk factors that may predict the development of high blood pressure," Lawrence said. "Just the fact that knowing your weight alone can help predict whether you will develop high blood pressure in the future is to our advantage because we can focus on that end point.

"It's an interesting observation," he added, "and kind of intuitive; it is in line with rapid rates of obesity in the African American community, and it parallels the high prevalence of hypertension in that population. So it's a two-for-one deal; theoretically, if we can get peoples' weight down then it will also help with hypertension."

The study was funded by the National Heart Lung and Blood Institute and the American Heart Association. Booth and Lawrence have no relevant financial relationships.

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