# Association of changes in body weight and waist circumference with a subsequent risk of developing hypertension in men requiring specific healthcare guidance

## TL;DR

This study finds that reducing body weight and waist circumference in men lowers their risk of developing hypertension, supporting Japan's health guidance program.

## Contribution

The study provides empirical evidence linking specific reductions in body weight and waist circumference to reduced hypertension risk in a large male population.

## Key findings

- Greater reductions in body weight and waist circumference were associated with progressively lower hypertension risk.
- Specific thresholds for body weight and waist circumference reductions showed significant risk reduction in hypertension incidence.

## Abstract

Although body weight (BW) and waist circumference (WC) reduction are key goals of Japan’s Specific Health Guidance program, limited evidence exists linking these reductions to a lower incidence of hypertension. This study aimed to evaluate the association between changes in BW and WC and the subsequent development of hypertension among men in a nationwide population. We retrospectively analyzed 23,109 men aged 40–64 years who required intensive health guidance and had no prior history of hypertension, using a nationwide database (DeSC Healthcare, Tokyo, Japan) from April 2014 to August 2023. One-year changes in BW and WC were examined for their association with incident hypertension using multivariable Cox regression and cubic spline analyses. During a mean follow-up of 1381 ± 789 days, 4162 men (18.0%) developed hypertension. Greater reductions in BW and WC were associated with a progressively lower risk of hypertension. In multivariable Cox models, BW reductions of ≤ −3.0 kg, −2.9 to −2.0 kg, and −1.9 to −1.0 kg were significantly associated with reduced hypertension risk (HR: 0.74 [95% CI: 0.67–0.82], 0.85 [0.76–0.96], and 0.89 [0.81–0.99], respectively). WC reductions of ≤ -3.0 cm and −2.9 to −2.0 cm were also significantly associated with reduced risk (HR: 0.80 [0.73–0.88] and 0.81 [0.72–0.92], respectively). Cubic spline analyses confirmed a monotonic decrease in hypertension risk with increasing BW and WC reduction. Among men eligible for Specific Health Guidance, one-year reductions in BW and WC were significantly associated with a lower risk of developing hypertension.