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Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels - A meta-analysis of 21 cohort studies including more than 300,000 persons

Bogers, Rik P.; Bemelmans, Wanda J. E.; Hoogenveen, Rudolf T.; Boshuizen, Hendriek C.; Woodward, Mark; Knekt, Paul; van Dam, Rob M.; Hu, Frank B.; Visscher, Tommy L. S. and Menotti, Alessandro, et al. (2007) In Archives of Internal Medicine 167(16). p.1720-1728
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, >= 30.0) 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... (More)
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, >= 30.0) 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=302296). 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-.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. (Less)
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published
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Archives of Internal Medicine
volume
167
issue
16
pages
1720 - 1728
publisher
American Medical Association
external identifiers
  • wos:000249343000003
ISSN
0003-9926
language
English
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yes
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09c023a9-578f-419b-8e76-16b266d3edf3 (old id 689648)
alternative location
http://archinte.ama-assn.org/cgi/content/abstract/167/16/1720
date added to LUP
2007-12-10 15:38:48
date last changed
2016-09-30 05:42:13
@article{09c023a9-578f-419b-8e76-16b266d3edf3,
  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, >= 30.0) 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=302296). 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-.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.},
  author       = {Bogers, Rik P. and Bemelmans, Wanda J. E. and Hoogenveen, Rudolf T. and Boshuizen, Hendriek C. and Woodward, Mark and Knekt, Paul and van Dam, Rob M. and Hu, Frank B. and Visscher, Tommy L. S. and Menotti, Alessandro and Thorpe, Roland J., Jr. and Jamrozik, Konrad and Calling, Susanna and Strand, Bjorn Heine and Shipley, Martin J.},
  issn         = {0003-9926},
  language     = {eng},
  number       = {16},
  pages        = {1720--1728},
  publisher    = {American Medical Association},
  series       = {Archives of Internal Medicine},
  title        = {Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels - A meta-analysis of 21 cohort studies including more than 300,000 persons},
  volume       = {167},
  year         = {2007},
}