For decades, obesity has been strongly associated with higher blood pressure and unhealthy cholesterol — and, through them, a greater risk of heart attacks and strokes. A large new study suggests that in several rich countries, that link has weakened for older adults, and points to a likely reason: medication.
What the study found
Researchers analyzed 110 health datasets covering almost one million people in seven high-income countries — England, the United States, Japan, South Korea, Taiwan, Thailand and Finland — over the period from 1990 to 2024, STAT News reported. The work, led by Majid Ezzati of Imperial College London and published in The Lancet, tracked how blood pressure and cholesterol differed between people with obesity and those with a normal body mass index (BMI), and how that gap changed over time.
The headline finding is striking. By the end of the study period, older adults with obesity in England and the United States — especially those with severe obesity — had blood pressure and cholesterol levels similar to, or in some cases lower than, older adults of normal weight. A gap that was once wide had, for these groups, largely closed.
Why it is happening
The authors argue the shift is best explained not by obesity becoming less harmful, but by treatment. Older people with obesity are now far more likely to be taking cholesterol-lowering drugs such as statins, and medication to control blood pressure, than they were three decades ago, according to Medical Xpress. By the early 2020s, the researchers estimated, roughly 70 to 72 percent of older men with severe obesity in these countries were taking such drugs, compared with about 40 to 48 percent of their normal-weight peers.
In other words, more intensive medical management appears to be doing the work — bringing two important risk factors under control in the group most likely to be treated.
Important caveats
The researchers and outside experts were careful about what the findings do and do not show. The study is observational: it tracks patterns across large populations rather than randomly assigning people to take medication or not, so it can reveal associations but cannot by itself prove cause and effect.
Crucially, the authors caution that the results should not be read as evidence that obesity has become benign. Blood pressure and cholesterol are only two of the ways excess weight can affect health; obesity is also linked to type 2 diabetes, certain cancers, kidney and liver disease, joint problems and chronic inflammation, which are not captured by those two measures. Lowering the numbers on a chart, experts note, is not the same as eliminating every risk.
The study also found little narrowing of the gap among younger adults, under 40, who with obesity still carried clearly higher risk markers — a reminder, several researchers said, that prevention earlier in life still matters.
What it means for patients
For doctors and patients, the study offers a measure of reassurance that widely used medicines are effective at controlling two major cardiovascular risk factors, even in people with obesity. But specialists were unanimous on one practical point: no one should start, stop or change statins or blood-pressure medication on the basis of a single study, and such decisions should be made with a doctor who knows the individual's circumstances.
The findings, limited to high-income countries with good access to medicines, may not hold in places where such treatment is harder to obtain — one more reason, the authors suggest, to view the result as a public-health success worth extending rather than a signal to relax.
