What role does obesity play in the development of cardiovascular disease events without co-morbid HTN, T2DM, or HLD? Great question during rounds on
@TGHCares Cardiology consults with @XavierPrida. Review on article published in @JACCJournals.
@USFIMres
@TGHCares Cardiology consults with @XavierPrida. Review on article published in @JACCJournals.
@USFIMres
Background:
- Obesity is established risk factor for CAD w/ global increase in past 40 years. Negative effects mediated by HTN, HLD, T2DM.
- "Metabolically healthy obese (MHO): Obese w/o metabolic abnormalities
- Obesity is established risk factor for CAD w/ global increase in past 40 years. Negative effects mediated by HTN, HLD, T2DM.
- "Metabolically healthy obese (MHO): Obese w/o metabolic abnormalities
Study Goal:
- Examine associations among body size phenotypes (underweight, normal, overweight, and obese) w/ and w/o metabolic abnormalities (T2DM, HTN, HLD) and incident CAD (angina, ischemic heart disease, MI), CVD (TIA, ischemic/hemorrhagic stroke), HF, and PVD
- Examine associations among body size phenotypes (underweight, normal, overweight, and obese) w/ and w/o metabolic abnormalities (T2DM, HTN, HLD) and incident CAD (angina, ischemic heart disease, MI), CVD (TIA, ischemic/hemorrhagic stroke), HF, and PVD
Methods:
- Cohort study w/ data collected from The Health Improvement Network (THIN) database, which captures diagnoses, prescriptions, hospital admissions. Had PCP records covering ~6.2% UK
- Data from January 1995-September 2015
- Participants ≥18 years w/ BMI included
- Cohort study w/ data collected from The Health Improvement Network (THIN) database, which captures diagnoses, prescriptions, hospital admissions. Had PCP records covering ~6.2% UK
- Data from January 1995-September 2015
- Participants ≥18 years w/ BMI included
Results:
- n= 3,495,777; with a total of 165,302 CVD events during 5.4 years average follow-up
- Those w/o metabolic abnormalities: 2.7% underweight, 37.7% normal weight, 25.7% overweight, 14.8% obese
- n= 3,495,777; with a total of 165,302 CVD events during 5.4 years average follow-up
- Those w/o metabolic abnormalities: 2.7% underweight, 37.7% normal weight, 25.7% overweight, 14.8% obese
Results:
- Overweight/Obese individuals w/o metabolic abnormalities had increased risk of CAD vs. normal weight w/o metabolic abnormalities
- Underweight and obese individuals w/o metabolic abnormalities had increased risk of CVD vs. normal weight w/o metabolic abnormalities
- Overweight/Obese individuals w/o metabolic abnormalities had increased risk of CAD vs. normal weight w/o metabolic abnormalities
- Underweight and obese individuals w/o metabolic abnormalities had increased risk of CVD vs. normal weight w/o metabolic abnormalities
Results:
- Underweight, Overweight/Obese w/o metabolic abnormalities had increased risk of HF vs. normal-weight individuals w/o metabolic abnormalities
- Risk of CAD, CVD, HF, PVD in normal weight, overweight/obese, increased w/ increased number of metabolic abnormalities
- Underweight, Overweight/Obese w/o metabolic abnormalities had increased risk of HF vs. normal-weight individuals w/o metabolic abnormalities
- Risk of CAD, CVD, HF, PVD in normal weight, overweight/obese, increased w/ increased number of metabolic abnormalities
Conclusions:
- Obese, but 'metabolically healthy' individuals still at increased risk for CAD, CVD, HF vs. normal weight individuals w/o metabolic risk factors
- Represents largest prospective study of body phenotypes + risk factors
- Continue to encourage prevention!
- Obese, but 'metabolically healthy' individuals still at increased risk for CAD, CVD, HF vs. normal weight individuals w/o metabolic risk factors
- Represents largest prospective study of body phenotypes + risk factors
- Continue to encourage prevention!
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