Prognostic significance of hypertension, overweight and obesity, as well as their combination for all-cause and cardiovascular mortality: a 34-year prospective study

Aim. To study the prognostic significance of hypertension (HTN), overweight, obesity, and their combination of HTN with overweight and obesity for all-cause and cardiovascular death risk based on a 34-year prospective study. Material and methods. The study was performed on the model of a Tomsk population (1546 people aged 20-59 years). At the stage of primary screening (19881991), blood pressure and anthropometry (height, weight) were measured, and the body mass index was calculated. After 34-year follow-up (2022), the effect of HTN, overweight, obesity, and their combination on all-cause and cardiovascular death risk was studied. Results. HTN in individuals with normal body weight increases the all-cause death risk by 1,9 times compared to individuals with normal body weight without HTN. Overweight in individuals without HTN increases the all-cause death risk by 1,3 times compared to those with normal body weight and blood pressure. In individuals only with obesity, the death risk is 1,7 times higher compared to those with normal body weight. Analysis of the effect of the studied predictors on cardiovascular mortality revealed similar patterns. The combination of HTN and overweight increases the risk of all-cause death by 2,1 times, and cardiovascular death by 3,4 times. The combination of HTN with obesity increases the risk of all-cause death by 2,6 times, and cardiovascular death by 5,1 times. In individuals with HTN, obesity additionally increases all-cause mortality by 1,4 times, and cardiovascular mortality by 2,3 times. The combined effect of HTN and obesity significantly worsens the prognosis of 34-year survival to 34,5% compared to 75,2% among people without these risk factors. Conclusion. The results of a 34-year prospective follow-up demonstrate a high prognostic significance of HTN, overweight and obesity, as well as a combination of HTN with overweight and obesity in the formation of all-cause and cardiovascular mortality.