Being Overweight With Poor Metabolic Health Raises Blood Pressure Risk, Study Finds

A new study from southwest China found that people who are obese and have poor metabolic health are much more likely to develop high blood pressure over time. Researchers followed more than 3,300 adults for about six years to track changes in their weight and health. The study was published in the International Journal of Obesity and gives doctors new clues about who is most at risk for high blood pressure.

High blood pressure, also called hypertension, is a serious health problem around the world. It can lead to heart disease, stroke, and other dangerous conditions. Scientists wanted to understand how a person's body weight and metabolic health — meaning how well their body processes energy — work together to affect blood pressure risk.

The researchers sorted the study participants into four groups based on their body weight and metabolic health. The groups were: healthy weight with good metabolism, healthy weight with poor metabolism, obese with good metabolism, and obese with poor metabolism. By tracking these groups over time, scientists could see how moving between groups changed a person's risk of getting high blood pressure.

Over the course of the study, 826 people developed high blood pressure. People who were obese with poor metabolic health had the highest risk — about 50 percent higher than people who had a healthy weight and good metabolic health. Even people who were obese but had good metabolic health still had a 26 percent higher risk of developing high blood pressure compared to the healthiest group.

One of the most important findings was that metabolic obesity is not a stable condition. About 31 percent of people who started out obese with good metabolic health got worse over time and moved into the obese with poor metabolic health group. This shows that being obese with good metabolic health does not mean a person is safe from future health problems.

On the brighter side, the study found that people who had poor metabolic health but a healthy weight were more likely to improve. About 37 percent of those people moved into the healthiest group during the study. This suggests that metabolic health can be changed, and that it may be possible to lower blood pressure risk by improving how the body processes energy.

Researchers also found that when people in any group moved to the healthiest category — normal weight with good metabolic health — their risk of developing high blood pressure did not go up significantly. This is an encouraging sign that lifestyle changes, like eating better and exercising more, could make a real difference. Scientists say future studies should look at whether early lifestyle programs can help people stay in or return to the healthiest group.