Adults with overweight or obesity were diagnosed with CVD at a younger age and lived longer with the disease compared with those with normal BMI, according to results presented at the American Heart Association’s Epidemiology and Prevention/Lifestyle and Cardiometabolic Health Scientific Sessions.
“Participants with a BMI 25 kg/m2 had a greater lifetime risk of [CVD] and lived a greater proportion of life with [CVD],” Sadiya Khan, MD, MSc, an instructor of medicine at Northwestern University Feinberg School of Medicine, told Cardiology Today. “Further, by implementing the life course approach in participants free of [CVD] at baseline, we were able to demonstrate earlier onset of [CVD].”
Researchers analyzed data from 170,205 participants, of whom 72,490 were aged 40 to 59 years (middle-aged group). Participants did not have CVD at baseline, and the mean baseline BMI for middle-aged men was 27.4 kg/m2 (standard deviation, 4.1) vs. 27.1 kg/m2 (standard deviation, 6) for middle-aged women, according to an abstract.
Upon follow-up (1.3 million person-years) for the middle-aged group, there were 13,457 CVD events reported, which included CHD, HF, stroke and death (n = 6,309), and 11,782 non-CVD deaths.
In the middle-aged group, lifetime risk for CVD increased among participants with obesity (BMI 30 kg/m2) or overweight (BMI, 25-29.9 kg/m2) compared with those with normal BMI. Participants who were middle-aged with normal BMI lived longer without CVD vs. those with obesity or overweight, who lived longer with CVD.
Among middle-aged men, compared with those with normal BMI, the competing HR for incident CVD was 1.21 (95% CI, 1.14-1.28) for those with a BMI of 25 kg/m2 to 29.9 kg/m2, 1.67 (95% CI, 1.55-1.79) for those with a BMI of 30 kg/m2 to 39.9 kg/m2 and 3.14 (95% CI, 2.48-3.97) for those with a BMI 40 kg/m2.
Among middle-aged women, compared with those with normal BMI, those with a BMI of 25 kg/m2 to 29.9 kg/m2 had a competing HR for CVD of 1.32 (95% CI, 1.24-1.4). For those with a BMI of 30 kg/m2 to 39.9 kg/m2, the competing HR for CVD was 1.85 (95% CI, 1.72-1.99), and for those with a BMI 40 kg/m2, it was 2.53 (95% CI, 2.2-2.91).
Researchers observed comparable patterns in participants of younger and older ages.
The researchers concluded the data suggest the “obesity/overweight paradox” exists because of sooner onset of CVD.
“One important difference is that our study included participants free of [CVD] at baseline,” Khan told Cardiology Today. “Further, our data suggest that the overweight and the obesity paradox may simply reflect earlier onset of the disease and greater number of years lived with [CVD].” – by Darlene Dobkowski
Khan S, et al. Presentation 9. Presented at American Heart Association’s Epidemiology and Prevention/Lifestyle and Cardiometabolic Health 2017 Scientific Sessions; March 7–10, 2017; Portland, Ore.
: Khan reports no relevant financial disclosures.