Weight and Cardiac Health in Middle Aged People in Khyber Pakhtunkhwa, Pakistan

<i>Method:</i> We examined how body weight affects cardiovascular health in adults aged 30–50 in Khyber Pakhtunkhwa (KPK), Pakistan, by analyzing de-identified records from hospitals (June 2022–March 2025). We calculated body mass index (BMI) and classified patients by WHO Asian criteria: normal (18.5–22.9), overweight (23.0–27.4), and obese (≥27.5 kg/m<sup>2</sup>). We recorded hypertension (HTN), coronary artery disease (CAD), myocardial infarction (MI), and arrhythmia, and applied statistical tests (ANOVA, logistic regression) to derive odds ratios (OR) with 95% confidence intervals (CI). <i>Results:</i> Mean age was 39.8 years (SD 5.7); 48% were female; 200 were normal-weight, 178 overweight, and 122 obese. Hypertension was present in 20.0%, 39.9%, and 58.2% of the normal, overweight, and obese participants (p<0.001). CAD rates were 4.5%, 6.7%, and 22.1%; MI rates were 2.5%, 9.6%, and 15.6% in the normal, overweight, and obese groups (p<0.001). Systolic BP rose from 120 mmHg (normal) to 139 mmHg (obese) (p<0.001), and BMI strongly correlated with BP (r≈0.50, p<0.001). In adjusted models, overweight vs normal had OR=2.70 (95% CI 1.61–4.52) and obese vs normal had OR=5.75 (3.34–9.91) for HTN (p<0.001). For CAD, obese vs normal had OR=6.14 (2.77–13.61, p<0.001); for MI, overweight had OR≈4.14 (1.04–16.47) and obese OR≈7.10 (2.69–18.70). Obesity also increased arrhythmia odds (OR≈2.79 [1.16–6.71]). ROC AUCs were 0.79 for both HTN (CI 0.74–0.84) and CAD (CI 0.72–0.86). <i>Conclusion:</i> Excess body weight is a major problem directly linked to high blood pressure and serious heart conditions, reflecting a global pattern. Preventing obesity should be a priority to reduce the growing heart disease burden in the region.