Trends in Obesity Prevalence Among Adults With Hypertension in the United States, 2001 to 2023

BACKGROUND: Obesity is a factor contributing to the occurrence of hypertension and a risk factor for adverse outcomes in populations with hypertension. The changes in the prevalence of obesity in populations with hypertension remain unclear. Investigating the changes in the prevalence of obesity in populations with hypertension can provide information for the treatment and management of hypertension. METHODS: The clinical data from adults aged ≥20 years with hypertension were extracted from the National Health and Nutrition Examination Survey 2001 to 2023. The primary outcome was the prevalence of obesity (body mass index≥30 kg/m 2 ). The trend in the prevalence of obesity among American adults with hypertension was evaluated via a trend test. RESULTS: The age-standardized prevalence of obesity among populations with hypertension in America increased from 39.6% in 2001 to 55.4% in 2023 ( P for trend<0.001). This trend was observed in male (35.4%–53.6%; P for trend<0.001) and female (45.6%–57.7%; P for trend<0.001) populations with hypertension. While the prevalence of grade II (35 kg/m 2 ≤body mass index<40 kg/m 2 ) and grade III obesity (body mass index≥40 kg/m 2 ) increased significantly in both sexes, the prevalence of grade I obesity (30 kg/m 2 ≤body mass index<35 kg/m 2 ) increased significantly only in males (23.2%–30.0%; P for trend=0.003) and did not significantly change in females (22.2%–21.7%; P for trend=0.135). CONCLUSIONS: The prevalence of obesity among American adults with hypertension increased from 2001 to 2023. In males, the prevalence of grades I, II, and III obesity increased. Among females, the prevalence of only grades II and III obesity increased.