Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women

Research output: Contribution to journalArticlepeer-review

Standard

Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women. / Caleyachetty, Rishi; Thomas, G. Neil; Toulis, Konstantinos A.; Mohammed, Nuredin; Gokhale, Krishna M.; Balachandran, Kumarendran; Nirantharakumar, Krishnarajah.

In: Journal of the American College of Cardiology, Vol. 70, No. 12, 19.09.2017, p. 1429-1437.

Research output: Contribution to journalArticlepeer-review

Harvard

APA

Vancouver

Author

Bibtex

@article{11555c772ea345869a11b870b1d063cf,
title = "Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women",
abstract = "Background: Previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals. Objectives: This study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population. Methods: We used linked electronic health records (1995 to 2015) in The Health Improvement Network (THIN) to assemble a cohort of 3.5 million individuals, 18 years of age or older and initially free of cardiovascular disease. We created body size phenotypes defined by body mass index categories (underweight, normal weight, overweight, and obesity) and 3 metabolic abnormalities (diabetes, hypertension, and hyperlipidemia). The primary endpoints were the first record of 1 of 4 cardiovascular presentations (coronary heart disease [CHD], cerebrovascular disease, heart failure, and peripheral vascular disease). Results: During a mean follow-up of 5.4 years, obese individuals with no metabolic abnormalities had a higher risk of CHD (multivariate-adjusted hazard ratio [HR]: 1.49; 95% confidence interval [CI]: 1.45 to 1.54), cerebrovascular disease (HR: 1.07; 95% CI: 1.04 to 1.11), and heart failure (HR: 1.96; 95% CI: 1.86 to 2.06) compared with normal weight individuals with 0 metabolic abnormalities. Risk of CHD, cerebrovascular disease, and heart failure in normal weight, overweight, and obese individuals increased with increasing number of metabolic abnormalities. Conclusions: Metabolically healthy obese individuals had a higher risk of coronary heart disease, cerebrovascular disease, and heart failure than normal weight metabolically healthy individuals. Even individuals who are normal weight can have metabolic abnormalities and similar risks for cardiovascular disease events.",
keywords = "cerebrovascular disease, coronary heart disease, heart failure, obesity, overweight, phenotype, weight",
author = "Rishi Caleyachetty and Thomas, {G. Neil} and Toulis, {Konstantinos A.} and Nuredin Mohammed and Gokhale, {Krishna M.} and Kumarendran Balachandran and Krishnarajah Nirantharakumar",
year = "2017",
month = sep,
day = "19",
doi = "10.1016/j.jacc.2017.07.763",
language = "English",
volume = "70",
pages = "1429--1437",
journal = "Journal of American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier",
number = "12",

}

RIS

TY - JOUR

T1 - Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women

AU - Caleyachetty, Rishi

AU - Thomas, G. Neil

AU - Toulis, Konstantinos A.

AU - Mohammed, Nuredin

AU - Gokhale, Krishna M.

AU - Balachandran, Kumarendran

AU - Nirantharakumar, Krishnarajah

PY - 2017/9/19

Y1 - 2017/9/19

N2 - Background: Previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals. Objectives: This study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population. Methods: We used linked electronic health records (1995 to 2015) in The Health Improvement Network (THIN) to assemble a cohort of 3.5 million individuals, 18 years of age or older and initially free of cardiovascular disease. We created body size phenotypes defined by body mass index categories (underweight, normal weight, overweight, and obesity) and 3 metabolic abnormalities (diabetes, hypertension, and hyperlipidemia). The primary endpoints were the first record of 1 of 4 cardiovascular presentations (coronary heart disease [CHD], cerebrovascular disease, heart failure, and peripheral vascular disease). Results: During a mean follow-up of 5.4 years, obese individuals with no metabolic abnormalities had a higher risk of CHD (multivariate-adjusted hazard ratio [HR]: 1.49; 95% confidence interval [CI]: 1.45 to 1.54), cerebrovascular disease (HR: 1.07; 95% CI: 1.04 to 1.11), and heart failure (HR: 1.96; 95% CI: 1.86 to 2.06) compared with normal weight individuals with 0 metabolic abnormalities. Risk of CHD, cerebrovascular disease, and heart failure in normal weight, overweight, and obese individuals increased with increasing number of metabolic abnormalities. Conclusions: Metabolically healthy obese individuals had a higher risk of coronary heart disease, cerebrovascular disease, and heart failure than normal weight metabolically healthy individuals. Even individuals who are normal weight can have metabolic abnormalities and similar risks for cardiovascular disease events.

AB - Background: Previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals. Objectives: This study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population. Methods: We used linked electronic health records (1995 to 2015) in The Health Improvement Network (THIN) to assemble a cohort of 3.5 million individuals, 18 years of age or older and initially free of cardiovascular disease. We created body size phenotypes defined by body mass index categories (underweight, normal weight, overweight, and obesity) and 3 metabolic abnormalities (diabetes, hypertension, and hyperlipidemia). The primary endpoints were the first record of 1 of 4 cardiovascular presentations (coronary heart disease [CHD], cerebrovascular disease, heart failure, and peripheral vascular disease). Results: During a mean follow-up of 5.4 years, obese individuals with no metabolic abnormalities had a higher risk of CHD (multivariate-adjusted hazard ratio [HR]: 1.49; 95% confidence interval [CI]: 1.45 to 1.54), cerebrovascular disease (HR: 1.07; 95% CI: 1.04 to 1.11), and heart failure (HR: 1.96; 95% CI: 1.86 to 2.06) compared with normal weight individuals with 0 metabolic abnormalities. Risk of CHD, cerebrovascular disease, and heart failure in normal weight, overweight, and obese individuals increased with increasing number of metabolic abnormalities. Conclusions: Metabolically healthy obese individuals had a higher risk of coronary heart disease, cerebrovascular disease, and heart failure than normal weight metabolically healthy individuals. Even individuals who are normal weight can have metabolic abnormalities and similar risks for cardiovascular disease events.

KW - cerebrovascular disease

KW - coronary heart disease

KW - heart failure

KW - obesity

KW - overweight

KW - phenotype

KW - weight

UR - http://www.scopus.com/inward/record.url?scp=85031117659&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2017.07.763

DO - 10.1016/j.jacc.2017.07.763

M3 - Article

C2 - 28911506

AN - SCOPUS:85031117659

VL - 70

SP - 1429

EP - 1437

JO - Journal of American College of Cardiology

JF - Journal of American College of Cardiology

SN - 0735-1097

IS - 12

ER -