Drugs have managed to equate the cholesterol of adults with and without obesity

This represents a significant change from 30 years ago and coincides with a greater increase in the use of drugs to reduce cholesterol (such as statins) and blood pressure, note the authors who publish the observational study in The Lancet.

Majid Ezzati, of the School of Public Health at Imperial College London and one of the authors, says the work suggests that, in high-income settings, medication to lower blood pressure and cholesterol has helped middle-aged and older adults lower their cardiovascular risk to levels similar to those of people with a normal BMI.

“At a time when weight loss medications are increasingly used, our results offer insight into the cardiovascular health of people likely to receive them (…),” the researcher adds in a statement.

The study analyzed data on blood pressure and cholesterol in people with obesity, overweight, and normal BMI from 110 data sets that included almost a million participants between 1990 and 2024, from the United Kingdom, the United States, Japan, South Korea, Taiwan, Thailand, and Finland.

The analysis reveals that, in the 1990s, Adults with obesity generally had higher levels of blood pressure and “bad cholesterol” than people with a normal BMI.

Since 1990, in most areas studied, blood pressure and unhealthy cholesterol decreased more sharply among middle-aged and older adults (ages 40 to 79) who were obese and overweight than among those with a normal BMI, with the difference narrowing over time.

The exceptions were Taiwan and Thailand, where this convergence was not as widely observed.

The findings were most notable in older adults (ages 60 to 79). In the United Kingdom and the United States, those with obesity, and especially those with severe obesity, had similar or even lower levels of unhealthy blood pressure and cholesterol than older adults with a normal BMI.

This is possibly because over the past three decades, people with obesity were more likely to receive medications to reduce the aforementioned risk factors than those with a normal BMI.

However, in young adults (under 40 years of age), the results show little or no reduction in the difference in blood pressure or cholesterol between people with obesity and those with a normal BMI.

Data indicate that drug use is low in this age group, which reinforces the idea that medication is “the determining factor” in reducing the gap in older adults.

The researchers, who are committed to considering early interventions in those under 40 years of age, point out some limitations of the study, among them that their analysis was limited to seven high-income areas, so the findings may not be applicable in other countries, especially in low- and middle-income ones.