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Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women
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Caleyachetty, Rishi, Thomas, G. Neil, Toulis, Konstantinos A., Mohammed, Nuredin, Gokhale, Krishna M., Balachandran, Kumarendran and Nirantharakumar, Krishnarajah (2017) Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women. Journal of the American College of Cardiology, 70 (12). pp. 1429-1437. doi:10.1016/j.jacc.2017.07.763 ISSN 0735-1097.
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Official URL: http://dx.doi.org/10.1016/j.jacc.2017.07.763
Abstract
Background:
Previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals.
Objectives:
This study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population.
Methods:
We used linked electronic health records (1995 to 2015) in The Health Improvement Network (THIN) to assemble a cohort of 3.5 million individuals, 18 years of age or older and initially free of cardiovascular disease. We created body size phenotypes defined by body mass index categories (underweight, normal weight, overweight, and obesity) and 3 metabolic abnormalities (diabetes, hypertension, and hyperlipidemia). The primary endpoints were the first record of 1 of 4 cardiovascular presentations (coronary heart disease [CHD], cerebrovascular disease, heart failure, and peripheral vascular disease).
Results:
During a mean follow-up of 5.4 years, obese individuals with no metabolic abnormalities had a higher risk of CHD (multivariate-adjusted hazard ratio [HR]: 1.49; 95% confidence interval [CI]: 1.45 to 1.54), cerebrovascular disease (HR: 1.07; 95% CI: 1.04 to 1.11), and heart failure (HR: 1.96; 95% CI: 1.86 to 2.06) compared with normal weight individuals with 0 metabolic abnormalities. Risk of CHD, cerebrovascular disease, and heart failure in normal weight, overweight, and obese individuals increased with increasing number of metabolic abnormalities.
Conclusions:
Metabolically healthy obese individuals had a higher risk of coronary heart disease, cerebrovascular disease, and heart failure than normal weight metabolically healthy individuals. Even individuals who are normal weight can have metabolic abnormalities and similar risks for cardiovascular disease events.
| Item Type: | Journal Article | ||||||||
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Journal of the American College of Cardiology | ||||||||
| Publisher: | Elsevier Inc. | ||||||||
| ISSN: | 0735-1097 | ||||||||
| Official Date: | 19 September 2017 | ||||||||
| Dates: |
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| Volume: | 70 | ||||||||
| Number: | 12 | ||||||||
| Page Range: | pp. 1429-1437 | ||||||||
| DOI: | 10.1016/j.jacc.2017.07.763 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Date of first compliant deposit: | 18 December 2017 | ||||||||
| Date of first compliant Open Access: | 19 September 2018 |
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