Living with Obesity for 10 or More Years Increases Heart Attack, Stroke Risk

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While elevated BMI at baseline was not associated with increased cardiovascular risk, cumulative excess BMI was associated with an increased risk in people under 50.

Living with obesity for 10 or more years is associated with an increased risk of stroke and heart attack in people who are under 50 years of age, according to recent research presented at the Endocrine Society’s 2024 annual meeting, held June 1 to 4 in Boston, Massachusetts.1 The data also showed that the risk was greater in men than in women.

Living with Obesity for 10 or More Years Increases Heart Attack, Stroke Risk / New Africa - stock.adobe.com

Living with Obesity for 10 or More Years Increases Heart Attack, Stroke Risk / New Africa - stock.adobe.com

The prevalence of obesity in the United States has been continually rising, with data from the CDC showing that over 40% of adults in the country live with the condition.2 Obesity is known to lead to the development of cardiovascular diseases, including stroke, venous thromboembolic disease, and pulmonary hypertension.3 However, it is not currently known if living with obesity over time increases the risk for cardiovascular disease further.

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“It is well established that people who have excess weight at any point in time have a greater risk of heart attacks and strokes,” Alexander Turchin, MD, MS, director of quality at the Division of Endocrinology at Brigham and Women’s Hospital and associate professor of medicine at Harvard Medical School, said in a release.1 “What was not known was whether it matters for how long someone has been exposed to excess weight.”

Investigators from Brigham and Women’s Hospital, in collaboration with Eli Lilly, conducted a study to determine if exposure to excess weight over time carries additional cardiovascular risk. Data was gathered from the Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS).

The study cohort included 136498 participants, of which 109259 were women and 27239 were men, with a mean baseline age of 48.6 years and BMI of 27.2 kg/m2. At baseline, 6862 participants had atherosclerotic cardiovascular disease, 3587 had type 2 diabetes, and 65101 had a history of smoking.

For the study, baseline demographic characteristics and comorbidities were taken in 1990 and participants were included if they had a BMI of more than 25 kg/m2 at least once between 1990 and 1999. Cardiovascular events that occurred from 2000 to 2020 were compared between participants with an annualized cumulative excess BMI in the fourth and first quartiles.

Investigators found that, in over 20 years of follow-up, there were 12048 cardiovascular events among the participants. While elevated BMI at baseline was not associated with increased cardiovascular risk, cumulative excess BMI was associated with an increased risk in women aged 35 years or younger and between 35 to 50 years of age. In men, cumulative excess BMI was associated with an increased risk for those aged 35 to 50 and 50 to 65.

Additionally, for women older than 50 and men older than 65, there was no difference in cardiovascular risk between first and fourth quartiles of excess BMI.

“Viewed as a ‘glass half full,’ these findings mean that obesity at any given point in time does not ‘seal’ one’s fate,” Turchin said in a release.1 “If obesity is treated in a timely fashion, its complications can be prevented.”

Click here for more of our coverage from ENDO 2024.

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References
1. Turchin A, Shubina M, Morrison FJ, et al. Cumulative Overweight Exposure over Time and Cardiovascular Risk. Presented at: ENDO 2024; June 1-4, 2024; Boston, MA.
2. Hales CM, Carroll MD, Fryar CD, et al. Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, no 360. Hyattsville, MD: National Center for Health Statistics. 2020
3. Powell-Wiley TM, Poirier P, Burke LE, et al. American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021 May 25;143(21):e984-e1010. doi: 10.1161/CIR.0000000000000973. Epub 2021 Apr 22. PMID: 33882682; PMCID: PMC8493650.
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