Obesity and the risk of myocardial infarction in 27 000 participants from 52 countries: a case-control study

Yusuf, Salim; Hawken, Steven; Ôunpuu, Stephanie; Bautista, Leonelo E.; Franzosi, Maria Grazia; Commerford, Patrick; Lang, Chim C.; Rumboldt, Zvonko; Onen, Churchill Lukwiya; Liu, Lisheng; Tanomsup, Supachai; Wangai, Paul; Razak, Fahad; Sharma, Arya M.; Anand, Sonia S.

doi:10.1016/s0140-6736(05)67663-5

Cited by 2,432 publications

(1,876 citation statements)

References 29 publications

Supporting

Mentioning

1,716

Contrasting

Unclassified

Order By: Relevance

“…We4, 5, 10 and others12, 13, 14 have shown that 1 or 2 metabolic syndrome traits confer increased risk of diabetes mellitus and CVD outcomes and that such persons are relatively insulin resistant. The problem with many reports minimizing the importance of the metabolically healthy obese condition is the inclusion of participants with 1 or 2 risk factors among metabolically healthy participants.…”

Section: Discussionmentioning

confidence: 97%

“…Obese persons who are free from cardiovascular disease (CVD) risk factors, such as hypertension, dyslipidemia, and hyperglycemia, are relatively insulin sensitive 4, 5, 6, 7, 8, 9. Epidemiological data indicate low risk of progression to diabetes mellitus and CVD outcomes among such people compared with obese persons with risk factors10, 11, 12, 13, 14 but increased risk of diabetes mellitus compared with healthy lean persons. These people experience low rates of incident diabetes mellitus and CVD, and their CVD risks are substantially reduced in comparison with either lean or obese persons who have the metabolic syndrome 10, 11, 12…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trends in Cardiovascular Health Metrics in Obese Adults: National Health and Nutrition Examination Survey (NHANES), 1988–2014

Guo

Garvey

2016

JAHA

View full text Add to dashboard Cite

BackgroundNo study has quantified trends in the prevalence of cardiovascular disease risk factors and cardiovascular health metrics among obese people in the United States in recent years.Methods and ResultsWe examined the secular changes in cardiovascular health metrics and key cardiovascular disease risk factors among obese adults (aged ≥20 years) in the United States. We included 18 626 obese adults (body mass index ≥30) from the National Health and Nutrition Examination Survey (NHANES) III and NHANES 1999–2014. Among those obese adults, there were decreases in mean systolic blood pressure, diastolic blood pressure, and total cholesterol levels and increases in mean high‐density lipoprotein cholesterol levels and mean hemoglobin A1c levels. Prevalence of blood pressure health and lipid health remained stable during the period 1988–2014, whereas prevalence of blood glucose health decreased significantly during this period. Prevalence of freedom from cardiovascular disease risk factors remained stable at ≈15% among the adult obese population during the period 1988–2014, whereas prevalence of presence of all 3 risk factors increased from 16.4% to 22.4% during this period, commensurate with a decline in those with 1 to 2 risk factors (from 69.6% to 62.4%).ConclusionsDuring the past 3 decades, blood pressure health and blood lipid health remained stable or improved, whereas blood glucose health deteriorated among adult obese population. This resulted in an overall decrease in cardiovascular health status among obese adults and greater risk of type 2 diabetes mellitus. The data argue for interventions targeted to those obese persons who are metabolically unhealthy to stem rising rates of diabetes mellitus.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Trends in Cardiovascular Health Metrics in Obese Adults: National Health and Nutrition Examination Survey (NHANES), 1988–2014

Guo

Garvey

2016

JAHA

View full text Add to dashboard Cite

show abstract

“…The importance of truncal fat is in line with many previous studies showing a strong correlation between abdominal fat accumulation and adverse health outcomes, such as an increased cardiovascular risk, dyslipidaemia, insulin resistance, and type 2 diabetes. 17–19 Importantly, total abdominal fat mass, as measured by waist circumference or DEXA, is determined by the mass of two distinct adipose tissue depots, the subcutaneous and the visceral depot, with the latter particularly contributing to the adverse effects of central obesity. 20,21 Weight loss is associated with overall reductions in total body fat mass, whereby there appears to be gender- and depot-specific differences.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Fat Distribution in Idiopathic Intracranial Hypertension Using Dual-Energy X-ray Absorptiometry Scanning

Hornby

Botfield

O’Reilly

et al. 2017

Neuro-Ophthalmology

View full text Add to dashboard Cite

Idiopathic intracranial hypertension (IIH) is strongly associated with obesity. We aimed to utilise dual-energy X-ray absorptiometry (DEXA) to characterise fat distribution, and to evaluate change in fat mass and distribution following weight loss. IIH patients (n = 24) had a similar fat distribution to body mass index (BMI)– and gender-matched obese controls (n = 47). In the IIH cohort, truncal fat mass correlated with lumbar puncture pressure. Weight loss in IIH patients resulted in a significant reduction in disease activity and fat mass, predominantly from the truncal region (−4.40 ± 1.6%; p = 0.008) compared with the limbs (+0.79 ± 6.5%; p = 0.71). These results indicate that, contrary to previous studies using waist-hip ratios, IIH adiposity is centripetal, similar to simple obesity. Future studies should establish the risk of the metabolic syndrome and the role of adipose tissue depot–specific function in IIH.

show abstract

“…Obesity is an important predictor of myocardial infarction (MI) and mortality in the general population 1, 2. However, several studies have revealed an obesity paradox in patients after MI: low body mass index (BMI) is associated with mortality in high‐risk patients with MI in the primary percutaneous coronary intervention era 3, 4, 5.…”

Section: Introductionmentioning

confidence: 99%

Body Mass Index and Sudden Cardiac Death in Japanese Patients After Acute Myocardial Infarction: Data From the JCAD Study and HIJAMI‐II Registry

Shiga

Kohro

Yamasaki

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundAlthough an “obesity paradox” exists in patients after myocardial infarction, the association between obesity and the risk of sudden cardiac death (SCD) is limited. The aim of this study was to determine whether obesity is associated with an increased risk of SCD in Japanese survivors of acute myocardial infarction.Methods and ResultsPooled data from 2 cohort studies in Japan, JCAD (Japanese Coronary Artery Disease) study and the Heart Institute of Japan Acute Myocardial Infarction‐II (HIJAMI‐II) registry, comprising of 6216 patients (mean age 65±11 years, 75.2% male) with acute myocardial infarction who were discharged alive, were studied. The patients were categorized into the following body mass index (BMI) groups at baseline according to the World Health Organization classification for Asian populations: BMI <18.5 kg/m2 (n=335), 18.5 to 23 kg/m2 (n=2371), 23 to 27.5 kg/m2 (n=2823), and ≥27.5 kg/m2 (n=687). The main outcomes were all‐cause mortality and SCD. During an average follow‐up period of 3.6±1.4 years, all‐cause mortality was 10.1%, and SCD was 1.2%. Patients with BMI <18.5 kg/m2 had the highest rate of all‐cause mortality (adjusted hazard ratio, 1.61; 95% confidence interval, 1.20–2.16), but high BMI (≥27.5 kg/m2) was not associated with mortality compared with patients in the group with BMI ≥18.5 and <23 kg/m2. However, the long‐term risk of SCD was increased in the group with BMI ≥27.5 kg/m2 (adjusted hazard ratio, 2.97; 95% confidence interval, 1.24–7.15). Multivariate analysis revealed that BMI ≥27.5 kg/m2 was associated with an increased risk of SCD (hazard ratio, 2.78; 95% confidence interval, 1.35–5.74).ConclusionsObesity (BMI ≥27.5 kg/m2) was associated with the risk of SCD in Japanese patients after myocardial infarction, although an obesity paradox was found for all‐cause mortality.

show abstract

Obesity and the risk of myocardial infarction in 27 000 participants from 52 countries: a case-control study

Cited by 2,432 publications

References 29 publications

Trends in Cardiovascular Health Metrics in Obese Adults: National Health and Nutrition Examination Survey (NHANES), 1988–2014

Trends in Cardiovascular Health Metrics in Obese Adults: National Health and Nutrition Examination Survey (NHANES), 1988–2014

Evaluating the Fat Distribution in Idiopathic Intracranial Hypertension Using Dual-Energy X-ray Absorptiometry Scanning

Body Mass Index and Sudden Cardiac Death in Japanese Patients After Acute Myocardial Infarction: Data From the JCAD Study and HIJAMI‐II Registry

Contact Info

Product

Resources

About