A Prospective Study of Body Mass Index, Weight Change, and Risk of Stroke in Women

Rexrode, Kathryn M

doi:10.1001/jama.1997.03540430051032

Cited by 472 publications

(232 citation statements)

References 39 publications

(1 reference statement)

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“…Some cohort studies have shown an increased risk of total stroke or ischemic stroke with elevating BMI, [8][9][10][11][12][13][14] which is in accord with the findings of the risk of ischemic stroke in our male subjects. On the other hand, other studies have found no association, [15][16][17][18] an inverse or a U-shaped association.…”

Section: Discussionsupporting

confidence: 89%

“…9,12,13,16,19,21,22 In the present study, we did not find a clear association between BMI levels and hemorrhagic stroke in men or women. The lack of a clear consensus on this association may be partly due to the low number of cases of hemorrhagic stroke in most of the studies, including our present work, or differences in ethnicities, study populations or study methods.…”

Section: Discussioncontrasting

confidence: 88%

“…9,10,[12][13][14]19,22 In our study, however, the association between BMI and ischemic stroke was not attenuated even after adjusting for these risk factors. This finding indicates an independent effect of overweight and obesity on the development of ischemic stroke.…”

Section: Discussioncontrasting

confidence: 81%

“…Several cohort studies have also examined the effects of BMI on the risk of ischemic stroke in women, 9,[13][14][15]21,22 but the findings were inconsistent, with some studies showing a positive association, 9,13,14 and others showing no association 15,21 like our study. Further studies will be needed to clarify the true association between BMI and stroke in women.…”

Section: Discussioncontrasting

confidence: 58%

“…7 Increased body mass index (BMI) is tightly related to an increased risk of coronary heart disease, 8 but its association with stroke is less well recognized because of conflicting results reported in the literature. Some cohort studies have found a positive association between BMI and the risk of stroke, [8][9][10][11][12][13][14] whereas others have shown no apparent association [15][16][17][18] or have even reported an inverse or a U-shaped association. [19][20][21][22] In Japan, no prospective study has provided incidence data on this issue nor observed a positive association between BMI and the risk of stroke until now.…”

Section: Introductionmentioning

confidence: 99%

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Body mass index and stroke incidence in a Japanese community: the Hisayama study

et al. 2010

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Although obesity is one of the major risk factors for coronary heart disease, its role in the development of stroke remains controversial. A total of 2421 residents, aged 40-79 years of a Japanese community were followed up prospectively for 12 years. The subjects were divided into four groups according to body mass index (BMI) levels (o21.0, 21.0-22.9, 23.0-24.9 and X25.0 kg m À2 ). During the follow-up, 107 ischemic and 51 hemorrhagic strokes occurred. The age-adjusted incidence of ischemic stroke for men significantly increased with increasing BMI levels (P for trend¼0.005). This association remained substantially unchanged even after adjustment for other risk factors: namely, systolic blood pressure, electrocardiogram abnormalities, diabetes, total cholesterol, high-density lipoprotein-cholesterol, triglycerides, smoking habits, alcohol intake and regular exercise (P for trendo0.001). Compared with that of the BMI levels of o21.0 kg m À2 , the multivariate-adjusted risk of ischemic stroke was significant even in the BMI levels of 23.0-24.9 kg m À2 (multivariate-adjusted hazard ratio (HR)¼3.12; 95% confidence interval (CI), 1.24-7.87; P¼0.02) as well as in the BMI levels of X25 kg m À2 (multivariate-adjusted HR¼5.59; 95% CI, 2.09-14.91; Po0.001). In stratified analyses, the risk of ischemic stroke for men synergistically increased in subjects having both obesity and diabetes or a smoking habit. We found no significant associations between BMI levels and ischemic stroke in women and between BMI levels and hemorrhagic stroke in either sex. In conclusion, our findings suggest that overweight and obesity are independent risk factors for ischemic stroke in Japanese men.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 88%

Section: Discussioncontrasting

confidence: 81%

Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

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Body mass index and stroke incidence in a Japanese community: the Hisayama study

et al. 2010

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Efficacy and Safety of Sibutramine in Obese White and African American Patients With Hypertension

McMahon¹,

Fujioka²,

Singh³

et al. 2000

Arch Intern Med

234

118

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In obese patients with controlled hypertension, sibutramine was an effective and well-tolerated treatment for weight loss and maintenance. Sibutramine-induced weight loss resulted in improvements in serum levels of triglycerides, HDL-C, uric acid, and glucose, and in waist circumference and quality-of-life measures. Blood pressure and heart rate increased by a small amount. Efficacy and safety profiles for sibutramine among African American and white obese patients with controlled hypertension were similar.

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Overweight, Obesity, and Health Risk

Billington¹,

Epstein²,

Goodwin³

et al. 2000

Arch Intern Med

856

105

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More than half of adult Americans are overweight or obese, and public health recommendations call for weight loss in those who are overweight with associated medical conditions or who are obese. However, some controversy exists in the lay press and in the medical literature about the health risks of obesity. We review briefly the large body of evidence indicating that higher levels of body weight and body fat are associated with an increased risk for the development of numerous adverse health consequences. Efforts to prevent further weight gain in adults at risk for overweight and obesity are essential. For those whose present or future health is at risk because of their obesity and who are motivated to make lifestyle changes, a recommendation for weight loss is appropriate.

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A Prospective Study of Body Mass Index, Weight Change, and Risk of Stroke in Women

Abstract: These prospective data indicate that both obesity and weight gain in women are important risk factors for ischemic and total stroke but not hemorrhagic stroke. The relationship between obesity and total stroke depends on the distribution of stroke subtypes in the population.

Cited by 472 publications

References 39 publications

Body mass index and stroke incidence in a Japanese community: the Hisayama study

Body mass index and stroke incidence in a Japanese community: the Hisayama study

Efficacy and Safety of Sibutramine in Obese White and African American Patients With Hypertension

Overweight, Obesity, and Health Risk

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