Obesity and Subtypes of Incident Cardiovascular Disease

Background Obesity is a risk factor for various subtypes of cardiovascular disease (CVD), including coronary heart disease (CHD), heart failure (HF), and stroke. Nevertheless, there are limited comparisons of the associations of obesity with each of these CVD subtypes, particularly regarding the ext...

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Bibliographic Details
Published in:Journal of the American Heart Association Vol. 5; no. 8
Main Authors: Ndumele, Chiadi E., Matsushita, Kunihiro, Lazo, Mariana, Bello, Natalie, Blumenthal, Roger S., Gerstenblith, Gary, Nambi, Vijay, Ballantyne, Christie M., Solomon, Scott D., Selvin, Elizabeth, Folsom, Aaron R., Coresh, Josef
Format: Journal Article
Language:English
Published: England John Wiley and Sons Inc 01.08.2016
Wiley
Subjects:
Adult
Aged
Atherosclerosis - epidemiology
Atherosclerosis - etiology
Body Mass Index
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
Coronary Disease - epidemiology
Coronary Disease - etiology
coronary heart disease
epidemiology
Female
heart failure
Heart Failure - epidemiology
Heart Failure - etiology
Humans
Male
Memory, Episodic
Middle Aged
obesity
Obesity, Morbid - complications
Obesity, Morbid - epidemiology
Original Research
Risk Factors
Sedentary Behavior
stroke
Stroke - epidemiology
Stroke - etiology
United States - epidemiology
epidemiology
heart failure
coronary heart disease
stroke
obesity
ISSN:2047-9980, 2047-9980
Online Access:Get full text
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Summary:Background Obesity is a risk factor for various subtypes of cardiovascular disease (CVD), including coronary heart disease (CHD), heart failure (HF), and stroke. Nevertheless, there are limited comparisons of the associations of obesity with each of these CVD subtypes, particularly regarding the extent to which they are unexplained by traditional CVD mediators. Methods and Results We followed 13 730 participants in the Atherosclerosis Risk in Communities (ARIC) study who had a body mass index ≥18.5 and no CVD at baseline (visit 1, 1987–1989). We compared the association of higher body mass index with incident HF, CHD, and stroke before and after adjusting for traditional CVD mediators (including systolic blood pressure, diabetes mellitus, and lipid measures). Over a median follow‐up of 23 years, there were 2235 HF events, 1653 CHD events, and 986 strokes. After adjustment for demographics, smoking, physical activity, and alcohol intake, higher body mass index had the strongest association with incident HF among CVD subtypes, with hazard ratios for severe obesity (body mass index ≥35 versus normal weight) of 3.74 (95% CI 3.24–4.31) for HF, 2.00 (95% CI 1.67–2.40) for CHD, and 1.75 (95% CI 1.40–2.20) for stroke (P<0.0001 for comparisons of HF versus CHD or stroke). Further adjustment for traditional mediators fully explained the association of higher body mass index with CHD and stroke but not with HF (hazard ratio 2.27, 95% CI 1.94–2.64). Conclusions The link between obesity and HF was stronger than those for other CVD subtypes and was uniquely unexplained by traditional risk factors. Weight management is likely critical for optimal HF prevention, and nontraditional pathways linking obesity to HF need to be elucidated.
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ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.116.003921