In the Journals

Overweight, obesity increase risk for sudden cardiac death in women

Overweight and obesity conferred elevated risk for sudden cardiac death in women throughout adulthood, according to 32-year results from the Nurses’ Health Study.

The association was especially prominent in those with severe obesity and when overweight or obesity was present in early adulthood, according to the researchers.

“We found that it is important to maintain a healthy weight throughout adulthood as a way to minimize the risk of sudden cardiac death,” Stephanie E. Chiuve, ScD, from the Center for Arrhythmia Prevention, department of medicine, Brigham and Women’s Hospital and Harvard Medical School, said in a press release.

Chiuve and colleagues analyzed 72,484 women free from chronic disease at baseline between 1980 and 2012. At baseline, they assessed height, weight and weight at age 18 years as remembered for each participant. Every 2 years, weight was reassessed.

The primary outcome was sudden cardiac death, which occurred in 445 women during the study period.

After adjustment for confounders, higher BMI updated biennially was associated with greater risk for sudden cardiac death (P for linear trend < .001), Chiuve and colleagues found.

Compared with BMI 21 kg/m2 to 22.9 kg/m2, BMI 25 kg/m2 to 29.9 kg/m2 was associated with a 46% increased risk for sudden cardiac death (RR = 1.46; 95% CI, 1.05-2.04), as was BMI 30 kg/m2 to 34.9 kg/m2 (RR = 1.46; 95% CI, 1-2.13), whereas BMI of at least 35 kg/m2 was associated with a more than twofold increased risk (RR = 2.18; 95% CI, 1.44-3.28), according to the researchers.

In women with BMI of at least 35 kg/m2, the elevated risk remained after adjustment for development of CHD during the study period and other mediators (RR = 1.72; 95% CI, 1.13-2.6), they wrote, noting that the risk was attenuated in the BMI 25 kg/m2 to 29.9 kg/m2 and 30 kg/m2 to 34.9 kg/m2 groups after those adjustments.

Elevated BMI at baseline was associated with greater risk for sudden cardiac death (P for trend < .001; P for quadratic trend = .27), and the trend was not affected by current BMI.

In addition, elevated BMI at age 18 years was associated with increased risk for sudden cardiac death (P for trend < .001; P for quadratic trend = .63). According to the researchers, elevated BMI at baseline and/or age 18 years had more of an association with higher sudden cardiac death risk than did current BMI.

“Our results support the hypothesis that obesity may be a stronger risk factor for [sudden cardiac death] in middle-aged vs. older populations,” Chiuve and colleagues wrote. “Therefore, excess weight or substantial weight gain may have an early and/or cumulative impact on [sudden cardiac death] risk that is not completely negated by weight loss later in life.” – by Erik Swain

Disclosure: Chiuve reports no relevant financial disclosures. One researcher reports receiving honoraria from Biosense Webster and St. Jude Medical. Another researcher reports receiving grant support from St. Jude Medical.

Overweight and obesity conferred elevated risk for sudden cardiac death in women throughout adulthood, according to 32-year results from the Nurses’ Health Study.

The association was especially prominent in those with severe obesity and when overweight or obesity was present in early adulthood, according to the researchers.

“We found that it is important to maintain a healthy weight throughout adulthood as a way to minimize the risk of sudden cardiac death,” Stephanie E. Chiuve, ScD, from the Center for Arrhythmia Prevention, department of medicine, Brigham and Women’s Hospital and Harvard Medical School, said in a press release.

Chiuve and colleagues analyzed 72,484 women free from chronic disease at baseline between 1980 and 2012. At baseline, they assessed height, weight and weight at age 18 years as remembered for each participant. Every 2 years, weight was reassessed.

The primary outcome was sudden cardiac death, which occurred in 445 women during the study period.

After adjustment for confounders, higher BMI updated biennially was associated with greater risk for sudden cardiac death (P for linear trend < .001), Chiuve and colleagues found.

Compared with BMI 21 kg/m2 to 22.9 kg/m2, BMI 25 kg/m2 to 29.9 kg/m2 was associated with a 46% increased risk for sudden cardiac death (RR = 1.46; 95% CI, 1.05-2.04), as was BMI 30 kg/m2 to 34.9 kg/m2 (RR = 1.46; 95% CI, 1-2.13), whereas BMI of at least 35 kg/m2 was associated with a more than twofold increased risk (RR = 2.18; 95% CI, 1.44-3.28), according to the researchers.

In women with BMI of at least 35 kg/m2, the elevated risk remained after adjustment for development of CHD during the study period and other mediators (RR = 1.72; 95% CI, 1.13-2.6), they wrote, noting that the risk was attenuated in the BMI 25 kg/m2 to 29.9 kg/m2 and 30 kg/m2 to 34.9 kg/m2 groups after those adjustments.

Elevated BMI at baseline was associated with greater risk for sudden cardiac death (P for trend < .001; P for quadratic trend = .27), and the trend was not affected by current BMI.

In addition, elevated BMI at age 18 years was associated with increased risk for sudden cardiac death (P for trend < .001; P for quadratic trend = .63). According to the researchers, elevated BMI at baseline and/or age 18 years had more of an association with higher sudden cardiac death risk than did current BMI.

“Our results support the hypothesis that obesity may be a stronger risk factor for [sudden cardiac death] in middle-aged vs. older populations,” Chiuve and colleagues wrote. “Therefore, excess weight or substantial weight gain may have an early and/or cumulative impact on [sudden cardiac death] risk that is not completely negated by weight loss later in life.” – by Erik Swain

Disclosure: Chiuve reports no relevant financial disclosures. One researcher reports receiving honoraria from Biosense Webster and St. Jude Medical. Another researcher reports receiving grant support from St. Jude Medical.