New research shows maintaining a healthy weight throughout life – more so than four other health behaviors studied – is important to help keep blood pressure in check, according to research presented at the American Heart Association (AHA) Council on Hypertension, AHA Council on Kidney in Cardiovascular Disease, American Society of Hypertension Joint Scientific Sessions 2017.

“Increasing blood pressure at younger ages is associated with earlier onset of heart disease and stroke, and U.S. high blood pressure treatment guidelines support maintaining healthy behaviors across the lifespan to limit rises in blood pressure as we age,” said John N. Booth III, PhD, postdoctoral fellow of the American Heart Association’s Strategically Focused Hypertension Research Network at the University of Alabama at Birmingham. “We looked specifically at the long-term impact of maintaining healthy behaviors on changes in blood pressure between early and middle-age adulthood.”

Researchers analyzed the impact of maintaining five health behaviors on blood pressure levels over 25 years:

• a healthy body weight, measured as a body mass index less than 25 kg/m^2;
• never smoking;
• zero to seven alcoholic drinks weekly for women and zero to 14 for men;
• 150 minutes or more moderate to vigorous physical activity per week; and
• eating a healthy diet, based on adhering to the Dietary Approaches to Stop Hypertension eating plan.

They assessed 4,630 participants of the Coronary Artery Risk Development in Young Adults Study, who were 18 to 30 years old in 1985 and 1986, when the study started. During the 25-year follow-up, researchers measured blood pressure and health behaviors eight times, until participants were in middle age.

They found:

• Participants who maintained a healthy body weight were more likely to have normal blood pressure as they grew older. Specifically, those who maintained optimal body weight were 41 percent less likely to have an increasing blood pressure as they aged.
• Maintaining physical activity or a healthy diet were not associated with changes in blood pressure during the 25-year period.
• Never smoking and maintaining no or moderate alcohol consumption were associated with less of an increase in blood pressure by middle age, but a larger study is needed to verify the connection.
• People in the study who maintained at least four health behaviors were 27 percent more likely to have a normal blood pressure than an increasing blood pressure from early adulthood through middle age.

“This data suggests that body weight is very important in terms of maintaining a normal blood pressure from early and into middle adulthood,” Booth said. “These results provide evidence that what we may want to do is focus on how we can create interventions that will enable individuals to maintain a normal body weight throughout their lifetimes. The other behaviors we studied may play an important role since they can influence body weight.”

In addition, while they were not as closely related to changes in blood pressure over time, Booth emphasized that the other health behaviors have clear benefits for overall cardiovascular health and help in weight maintenance. “The American Heart Association recommends maintaining healthy behaviors to prevent risk factors for heart disease and stroke from developing, including high blood pressure.”

Co-authors are Norrina B. Allen, PhD; April P. Carson, PhD; David Calhoun, MD; Daichi Shimbo, MD; James M. Shikany, DrPh; Cora E. Lewis, MD; David T. Redden, PhD; and Paul Muntner, PhD.