Originally published by 2 Minute Medicine^® (view original article). Reused on AccessMedicine with permission.

1. In this cohort of adults in the United Kingdom (UK), those with a thinner or plumper body size in childhood had an increased risk of adult incident hypertension compared to those who remained of average size.

Evidence Rating Level: 1 (Excellent)

Obesity is a worldwide public health problem affecting individuals across all ages and denominations. It is well known that there is a connection between obesity in adults and increased risk of hypertension, although, the mechanism underlying the connection is not well understood. As such, the goal of this study is to understand the association between weight changes from childhood to adulthood and the incidence of hypertension. Individuals were selected through the UK Biobank. Childhood body habitus was determined by asking the participants how they would compare themselves to the average, while adult weight was measured at baseline. A total of 180 527 participants (59.4% females) were included in the study, with 16 491 developing incident hypertension. Compared to individuals who maintained an average body weight from childhood to adulthood, those who went from average to overweight (hazards ratio (HR) = 1.46, 95% CI = 1.39-1.54) and average to obese (HR = 2.45, CI = 2.31-2.61) had a higher risk of incident hypertension. The individuals with the highest incidence risk were those who went from thin weight in childhood to obese in adulthood (HR = 3.09, 95% CI = 2.88-3.32) once again compared to those who maintained an average weight. The second lowest risk was the individuals who went from a larger to an average size compared to the normal weight group (HR = 1.11, 95% CI = 1.10-1.23). Obesity (mediation proportion: 58.7%, 95% CI: 40.4-74.8%) and overweight body habitus in adulthood played a significant role in mediating the link between a plumper body size in childhood and the development of hypertension. one biological factor mediating the risk of hypertension was the concentration of HDL. A higher concentration of HDL was inversely associated with obesity. Overall, these findings indicate that there is an increased risk of developing hypertension in individuals who were thinner or plumper in childhood, with the highest risk in when obese adults were thinner in childhood.

Click to read the study in BMC Medicine

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