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Overweight and obesity as determinants of cardiovascular risk: the Framingham experience.

Abstract

BACKGROUND

To our knowledge, no single investigation concerning the long-term effects of overweight status on the risk for hypertension, hypercholesterolemia, diabetes mellitus, and cardiovascular sequelae has been reported.

METHODS

Relations between categories of body mass index (BMI), cardiovascular disease risk factors, and vascular disease end points were examined prospectively in Framingham Heart Study participants aged 35 to 75 years, who were followed up to 44 years. The primary outcome was new cardiovascular disease, which included angina pectoris, myocardial infarction, coronary heart disease, or stroke. Analyses compared overweight (BMI [calculated as weight in kilograms divided by the square of height in meters], 25.0-29.9) and obese persons (BMI > or =30) to a referent group of normal-weight persons (BMI, 18.5-24.9).

RESULTS

The age-adjusted relative risk (RR) for new hypertension was highly associated with overweight status (men: RR, 1.46; women: RR, 1.75). New hypercholesterolemia and diabetes mellitus were less highly associated with excess adiposity. The age-adjusted RR (confidence interval [CI]) for cardiovascular disease was increased among those who were overweight (men: 1.21 [1.05-1.40]; women: 1.20 [1.03-1.41]) and the obese (men: 1.46 [1.20-1.77]; women: 1.64 [1.37-1.98]). High population attributable risks were related to excess weight (BMI > or =25) for the outcomes hypertension (26% men; 28% women), angina pectoris (26% men; 22% women), and coronary heart disease (23% men; 15% women).

CONCLUSIONS

The overweight category is associated with increased relative and population attributable risk for hypertension and cardiovascular sequelae. Interventions to reduce adiposity and avoid excess weight may have large effects on the development of risk factors and cardiovascular disease at an individual and population level.

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  • Authors+Show Affiliations

    ,

    Boston University School of Medicine, 715 Albany St, Evans 204, Boston, MA 02118, USA. pwilson@bumc.bu.edu

    , , ,

    Source

    Archives of internal medicine 162:16 2002 Sep 09 pg 1867-72

    MeSH

    Adult
    Aged
    Angina Pectoris
    Body Mass Index
    Confidence Intervals
    Coronary Disease
    Cross-Sectional Studies
    Diabetes Mellitus
    Female
    Humans
    Hypercholesterolemia
    Hypertension
    Incidence
    Male
    Middle Aged
    Obesity
    Prospective Studies
    Risk
    Sex Factors
    Stroke
    Time Factors
    United States

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    12196085

    Citation

    Wilson, Peter W F., et al. "Overweight and Obesity as Determinants of Cardiovascular Risk: the Framingham Experience." Archives of Internal Medicine, vol. 162, no. 16, 2002, pp. 1867-72.
    Wilson PW, D'Agostino RB, Sullivan L, et al. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med. 2002;162(16):1867-72.
    Wilson, P. W., D'Agostino, R. B., Sullivan, L., Parise, H., & Kannel, W. B. (2002). Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Archives of Internal Medicine, 162(16), pp. 1867-72.
    Wilson PW, et al. Overweight and Obesity as Determinants of Cardiovascular Risk: the Framingham Experience. Arch Intern Med. 2002 Sep 9;162(16):1867-72. PubMed PMID: 12196085.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. AU - Wilson,Peter W F, AU - D'Agostino,Ralph B, AU - Sullivan,Lisa, AU - Parise,Helen, AU - Kannel,William B, PY - 2002/8/28/pubmed PY - 2002/10/17/medline PY - 2002/8/28/entrez SP - 1867 EP - 72 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 162 IS - 16 N2 - BACKGROUND: To our knowledge, no single investigation concerning the long-term effects of overweight status on the risk for hypertension, hypercholesterolemia, diabetes mellitus, and cardiovascular sequelae has been reported. METHODS: Relations between categories of body mass index (BMI), cardiovascular disease risk factors, and vascular disease end points were examined prospectively in Framingham Heart Study participants aged 35 to 75 years, who were followed up to 44 years. The primary outcome was new cardiovascular disease, which included angina pectoris, myocardial infarction, coronary heart disease, or stroke. Analyses compared overweight (BMI [calculated as weight in kilograms divided by the square of height in meters], 25.0-29.9) and obese persons (BMI > or =30) to a referent group of normal-weight persons (BMI, 18.5-24.9). RESULTS: The age-adjusted relative risk (RR) for new hypertension was highly associated with overweight status (men: RR, 1.46; women: RR, 1.75). New hypercholesterolemia and diabetes mellitus were less highly associated with excess adiposity. The age-adjusted RR (confidence interval [CI]) for cardiovascular disease was increased among those who were overweight (men: 1.21 [1.05-1.40]; women: 1.20 [1.03-1.41]) and the obese (men: 1.46 [1.20-1.77]; women: 1.64 [1.37-1.98]). High population attributable risks were related to excess weight (BMI > or =25) for the outcomes hypertension (26% men; 28% women), angina pectoris (26% men; 22% women), and coronary heart disease (23% men; 15% women). CONCLUSIONS: The overweight category is associated with increased relative and population attributable risk for hypertension and cardiovascular sequelae. Interventions to reduce adiposity and avoid excess weight may have large effects on the development of risk factors and cardiovascular disease at an individual and population level. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/12196085/Overweight_and_obesity_as_determinants_of_cardiovascular_risk:_the_Framingham_experience_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/162/pg/1867 DB - PRIME DP - Unbound Medicine ER -