Metabolically Healthy Obese and Incident Cardiovascular Disease Events Among 3.5 Million Men and Women

Previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals. This study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population. We used lin...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2017-09, Vol.70 (12), p.1429-1437
Main Authors: Caleyachetty, Rishi, Thomas, G. Neil, Toulis, Konstantinos A., Mohammed, Nuredin, Gokhale, Krishna M., Balachandran, Kumarendran, Nirantharakumar, Krishnarajah
Format: Article
Language:English
Subjects:
Abnormalities
Adult
Body mass
Body mass index
Body size
Body weight
Cardiology
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
cerebrovascular disease
Confidence intervals
Coronary artery disease
coronary heart disease
Diabetes mellitus
Electronic health records
Electronic medical records
Female
Health risk assessment
Health risks
Heart
Heart diseases
Heart failure
Humans
Hyperlipidemia
Hypertension
Incidence
Male
Middle Aged
Obesity
Obesity - complications
Obesity - metabolism
Overweight
phenotype
Prospective Studies
Risk
Risk Assessment
Underweight
weight
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals. This study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population. 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). 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. 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. [Display omitted]
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2017.07.763