Humans

Rising body roundness links to hypertension in older adults

Compared with a low-level inverted U-shaped trajectory, non-diabetic adults with a high-level increasing body roundness trajectory had an adjusted odds ratio of 1.76 for incident hypertension.

Global Heart4 Oct 2026, 08:54 BST

In a prospective cohort of 4,522 non-diabetic Chinese adults aged 45 and older, researchers tracked body roundness index (BRI)—a measure of waist circumference relative to height—across three survey waves. Group-based modeling identified three trajectories: low-level inverted U-shaped, moderate-level inverted U-shaped, and high-level increasing. Incident hypertension occurred in 12%, 17%, and 23% of participants across these respective groups during subsequent follow-up.

Compared to the low-level group, multivariable-adjusted odds ratios for incident hypertension were 1.40 for the moderate pattern and 1.76 for the high-level increasing pattern. An external validation cohort of 1,105 English adults yielded consistent results, with an adjusted odds ratio of 1.67 for the high-level increasing trajectory. Machine learning models confirmed that BRI trajectories added predictive value when combined with age, C-reactive protein, and lipid markers.

Why it matters

Central adiposity shifts during aging, driving vascular stiffening and chronic metabolic stress. Tracking dynamic changes in body shape over time provides a clearer picture of emerging cardiovascular risk than static, one-time measurements.

Caveats

The observational design cannot prove that increases in body roundness directly cause hypertension. In addition, the English validation cohort was relatively small, including only 106 participants in the high-level increasing trajectory group.