We use cookies to provide you with the best possible website experience. This includes cookies that are necessary for the operation of the site, as well as cookies used for anonymous statistics, comfort settings, or displaying personalized content. You can decide which categories you want to allow. Please note that depending on your settings, some features of the website may not be available.

Cookie settings

These necessary cookies are required to enable the core functionality of the website. Opting out of these cookies is not possible.

cb-enable
This cookie stores the user's cookie consent status for the current domain. Expiry: 1 year.
laravel_session
Stores the session ID to recognize the user when the page reloads and to restore their login session. Expiry: 2 hours.
XSRF-TOKEN
Provides CSRF protection for forms. Expiry: 2 hours.
IZA Discussion Paper No. 18748
June 2026
The Causal Effect of BMI on Hypertension: A Copula Model Approach with Genetic Risk Instruments
Robinson Dettoni, Petri Böckerman, Cliff Bahamondes, Jose Vasquez, Carlos Yévenes, Olli Raitakari, Jutta Viinikainen, Terho Lehtimäki, Jaakko Pehkonen

This paper estimates the causal effect of body mass index (BMI) on hypertension risk using data from the Young Finns Study. The empirical framework combines genetic instruments for BMI with a triangular copula model that accommodates a binary outcome and a continuous endogenous treatment, allowing unobserved determinants of BMI and hypertension to be correlated through alternative symmetric and asymmetric copula specifications. Sensitivity analyses examine alternative copula families and nested BMI genetic-score constructions to address pleiotropy concerns. The results show that higher BMI increases hypertension risk across ordered blood-pressure severity categories. Probability-scale treatment effects reveal a nonlinear pattern: marginal risk is concentrated in clinically relevant regions of the BMI distribution and shifts from early blood-pressure elevation toward more severe hypertension as body mass increases. The findings illustrate how genetic instruments and copula-based triangular models can be combined to study endogenous continuous treatments with nonlinear health outcomes, while identifying where along the BMI distribution marginal increases in body mass are most consequential for blood-pressure risk.

Communications
Mark Fallak
mark.fallak@liser.lu
+352 585-855-526
World of Labour
Olga Nottmeyer
olga.nottmeyer-ext@liser.lu
+352 585-855-501
Network Coordination
Christina Gathmann
christina.gathmann@liser.lu

The IZA@LISER Network is a global community of scholars dedicated to excellence in labor economics and related fields, now coordinated at the Luxembourg Institute of Socio-Economic Research (LISER) following its transition from Bonn.

About IZA@LISER Network
Contact
IZA@LISER NETWORK (Current Site Operator):

Luxembourg Institute of Socio-Economic Research (LISER)
11, Porte des Sciences
Maison des Sciences Humaines
L-4366 Esch-sur-Alzette / Belval, Luxembourg

IZA Institute (In Liquidation):

Forschungsinstitut zur Zukunft der Arbeit GmbH i. L.
Schaumburg-Lippe-Str. 5-9, 53113 Bonn. Germany
Phone: +49 228 3894-0 | Fax: +49 228 3894-510
E-Mail: info@iza.org | Web: www.iza.org
Represented by: Martin T. Clemens (Liquidator)