Trends in cardiometabolic risk factors according to body mass index in Peru between 2015 and 2023

Background: Global evidence has shown rising trends in the prevalence of cardiometabolic risk factors. Whether the same trends are observed according to body mass index (BMI) cut-offs is unknown, though critical to focus on specific BMI populations. Methods: We conducted a pooled analysis of national health surveys in Peru, grouped into three-year periods (2015–17 [n = 97,079], 2018–20 [n = 98,540], 2021–23 [n = 94,850]). BMI (kg/m²) was classified into four categories: normal weight (18–24.9), overweight (25–29.9), obesity I (30–34.9), and obesity II (≥35). For each period-BMI category, we computed the age-sex-standardized prevalence of cardiometabolic risk factors: raised blood pressure with and without self-reported antihypertensive treatment, self-reported diabetes with and without treatment, daily smoking, alcohol consumption in the last month, and fruits/vegetables consumption in the last week. Results: The proportion of people with raised blood pressure increased in the overweight and obesity groups, with the largest increase observed in the obesity II group (22 % relative increase). Diabetes prevalence rose substantially among normal weight (89 %) and overweight individuals (58 %). Smoking, alcohol, and fruit/vegetable consumption showed no major changes across BMI categories. Conclusions: The prevalence of raised blood pressure has increased between 2015 and 17 and 2020–23, with greater increases observed in the overweight and obesity groups; conversely, the prevalence of self-reported diabetes has increased across BMI categories. These findings highlight the need for tailored interventions targeting both overweight/obese individuals and normal weight populations with diabetes risk.