Midlife Obesity May Cause Heart Disease

A large, long-term follow-up studyrevealed that obesity at middle age canlead to heart disease even when obviousrisk factors, such as high blood pressure(BP) and high cholesterol, are absent. Thestudy, out of Chicago's NorthwesternUniversity, included 17,643 peoplewhose body mass index (BMI) and cardiovascularrisk factors were assessed atmidlife—considered to be between theages of 31 and 64—between 1967 and1973. They were followed through 2002,and their rates of hospitalization anddeath from coronary heart disease(CHD), cardiovascular disease, and diabeteswere assessed. The study groupwas subdivided into 5 groups: nonsmokerswith normal BP whose cholesterolwas <200 mg/dL without the aid of medication(low risk); nonsmokers not onmedication but with slightly elevated BPand cholesterol (moderate risk); andthose with 1, 2, or 3 risk factors of highBP, high cholesterol, and active smoking(intermediate, elevated, and highest risk).Study groups were further divided bytheir BMI—normal, overweight, or obese.Moderate-risk, obese patients had twicethe risk of CHD death and hospitalizationafter age 65, compared with their normal-weight counterparts. Among the lowrisk group, obesity increased the CHDdeath and hospitalization rates by 1.43-fold and 4.25-fold, respectively. Bothgroups had a 7-fold increase in diabetesrisk if patients were obese. In the intermediate-,elevated-, and highest-riskgroups, being overweight was associatedwith poor health but not to the magnitudethat obesity supports. Lead authorLijing L. Yan, PhD, MPH, said that she wassurprised at how "just one BMI measurementin midlife could so strongly predictoutcomes in older age."

Ms. Farley is a freelance medicalwriter based in Wakefield, RI.