Sadiya S. Khan
Patients with obesity had an increased risk for CV morbidity and mortality and typically had shorter longevity compared with those with normal BMI, according to a study published in JAMA Cardiology.
Those with overweight also had an increased risk for developing CVD at a younger age.
“We hope these data help provide much needed clarity for individual patients about the adverse heart risks of being overweight and obese that may have been unclear and confusing in the past in terms of the obesity paradox,” Sadiya S. Khan, MD, MSC, assistant professor of medicine and preventive medicine at Northwestern University School of Medicine, told Cardiology Today.
Researchers analyzed data from 190,672 patients (74% women; mean age for men, 46 years; mean age for women, 59 years) from 10 prospective cohort studies who were free from clinical CVD at baseline. Patients from these studies had at least one examination that included weight and height measurements, at least 10 years of follow-up and surveillance and adjudication for all subtypes of CV events and non-CV death.
The information was used to calculate lifetime and cumulative risk for CVD events and non-CVD death. Patients were categorized by sex, age and BMI. Data included 3.2 million person-years of follow-up conducted until 2015.
Both men and women who were middle-aged (aged 40-59 years) and were overweight or obese had an increased lifetime risk for incident CVD events and CVD death vs. those with normal BMI (18.5-24.9 kg/m2).
Compared with patients with normal BMI, men and women who were middle-aged and overweight (BMI, 25-29.9 kg/m2) had a competing HR for incident CVD of 1.21 (95% CI, 1.14-1.28) and 1.32 (95% CI, 1.24-1.4), respectively. In those with obesity (BMI, 30-39.9 kg/m2), men had a competing HR of 1.67 (95% CI, 1.55-1.79) and women had a competing HR of 1.85 (95% CI, 1.72-1.99). The highest competing HRs were seen in men (HR = 3.14; 95% CI, 2.48-3.97) and women (HR = 2.53; 95% CI, 2.2-2.91) with morbid obesity (BMI 40 kg/m2).
Patients with higher BMI had the greatest HRs for incident HF among CVD subtypes.
Men and women who were middle-aged and had normal BMI had the shortest average years lived with CVD vs. those with higher BMI, which resulted in a relative compression of morbidity. Younger and older men and women had similar patterns.
“The obesity paradox led to confusion about weight-loss recommendations, which may have been detrimental toward overall health span and life span,” Khan said in an interview. “We believe that these data support primordial prevention on an individual and population level with the goal of maintaining a healthy BMI for a longer, healthier life free of cardiovascular disease.” – by Darlene Dobkowski
For more information:
Sadiya S. Khan, MD, MSC, can be reached at firstname.lastname@example.org.
The authors report no relevant financial disclosures.