A global review published in The Lancet has revealed that obese people aged over 40 are no longer at higher risk of heart attack compared to individuals of healthy weight, thanks to the widespread use of cholesterol-lowering drugs like statins and antihypertensives.
Study Findings on Cardiovascular Risk
The study, which analyzed data on one million adults from England, Japan, South Korea, Taiwan, Thailand, Finland, and the United States, found that differences in unhealthy cholesterol levels and blood pressure between older adults have "narrowed or disappeared" in developed nations. In some cases, obese individuals were found to have better cholesterol and blood pressure levels than their normal-weight counterparts.
Lead author Professor Majid Ezzati of Imperial College London stated: "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."
Implications for Weight Loss Drugs
Professor Ezzati added: "At a time that weight-loss medications are becoming more widely used, our results give a picture of the cardiovascular health of people likely to be prescribed them, which allows the healthcare system to understand how blood pressure and cholesterol treatments benefit the population alongside weight-loss medications."
The research examined data on blood pressure, cholesterol levels, and body mass index (BMI) from 110 health surveys conducted between 1990 and 2024, including information on the use of statins and antihypertensives.
Age-Related Differences
Historically, carrying excess weight was associated with higher blood pressure and unhealthy cholesterol. However, the new study found this is no longer the case for adults over 40 in developed nations. In contrast, among adults under 40, those who were obese still exhibited higher levels of bad cholesterol and elevated blood pressure.
Expert Commentary
Professor Bryan Williams, chief scientific and medical officer at the British Heart Foundation, commented: "This study highlights a powerful public health success story - it shows just how effective modern treatments for blood pressure and cholesterol have become, with many people over 40 with obesity now reaching levels similar to those with a healthy weight. This is testament to the impact of cardiovascular disease prevention strategies, the use of widely available and highly effective medicines, and the importance of people taking them as prescribed."
However, Professor Williams cautioned: "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. Moreover, obesity still affects the body in many other ways and increases the risk of other health problems, including diabetes, kidney disease and some cancers. Preventing and reducing obesity would result in a range of health benefits, in many cases without the need for these additional medicines."
