Association of Overweight With Increased Risk of Coronary Heart Disease Partly Independent of Blood Pressure and Cholesterol Levels<subtitle>A Meta-analysis of 21 Cohort Studies Including More Than 300 000 Persons</subtitle>

Abstract

Background:The extent to which moderate overweight (body mass index [BMI], 25.0-29.9 [calculated as weight in kilograms divided by height in meters squared]) and obesity (BMI, Ն30.0) are associated with increased risk of coronary heart disease (CHD) through adverse effects on blood pressure and cholesterol levels is unclear, as is the risk of CHD that remains after these mediating effects are considered.Methods: Relative risks (RRs) of CHD associated with moderate overweight and obesity with and without adjustment for blood pressure and cholesterol concentrations were calculated by the members of a collaboration of prospective cohort studies of healthy, mainly white persons and pooled by means of random-effects models (RRs for categories of BMI in 14 cohorts and for continuous BMI in 21 cohorts; total N = 302 296).Results: A total of 18 000 CHD events occurred during follow-up. The age-, sex-, physical activity-, and smoking-adjusted RRs (95% confidence intervals) for moderate overweight and obesity compared with normal weight were 1.32 (1.24-1.40) and 1.81 (1.56-2.10), respectively. Additional adjustment for blood pressure and cholesterol levels reduced the RR to 1.17 (1.11-1.23) for moderate overweight and to 1.49 (1.32-1.67) for obesity. The RR associated with a 5-unit BMI increment was 1.29 (1.22-1.35) before and 1.16 (1.11-1.21) after adjustment for blood pressure and cholesterol levels.Conclusions: Adverse effects of overweight on blood pressure and cholesterol levels could account for about 45% of the increased risk of CHD. Even for moderate overweight, there is a significant increased risk of CHD independent of these traditional risk factors, although confounding (eg, by dietary factors) cannot be completely ruled out.

American‐Style Football and Cardiovascular Health

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Overweight and weight dissatisfaction related to socio-economic position, integration and dietary indicators among South Asian immigrants in Oslo

“…Such knowledge is of great importance in the work to reduce the prevalence of overweight/obesity and related chronic diseases in the immigrant population (18,19) .…”

Negative Carotid Artery Remodeling in Early Type 2 Diabetes Mellitus and Increased Carotid Plaque Vulnerability in Obesity as Assessed by Magnetic Resonance Imaging

“…Obesity, being one of the components of the metabolic syndrome,37 is associated with other cardiovascular risk factors including hypertension, T2DM, and hyperlipidemia leading to increased cardiovascular mortality 38, 39. Our data using carotid MRI strongly support the notion of obesity being a major risk factor for developing advanced carotid atherosclerosis since BMI ≥30.0 kg/m 2 was positively associated with both necrotic core size and increased carotid artery calcification and negatively associated with loose matrix size compared with BMI <25.0 kg/m 2 .…”