AHA EPI/Lifestyle and Cardiometabolic Health Scientific Sessions
AHA EPI/Lifestyle and Cardiometabolic Health Scientific Sessions
Perspective from Robert H. Eckel, MD
March 10, 2017
2 min read
Save

CVD onset occurs earlier in people with higher BMI

Perspective from Robert H. Eckel, MD
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

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.

Sadiya Khan

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

Reference:

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.

Disclosure : Khan reports no relevant financial disclosures.