Overweight and Obesity as Determinants of Cardiovascular Risk: The Framingham Experience
Abstract
Background To our knowledge, no single investigation concerning the long-term effects of overweight status on the risk for hypertension, hypercholesterolemia, diabetes mellitus, and cardiovascular sequelae has been reported. Methods Relations between categories of body mass index (BMI), cardiovascular disease risk factors, and vascular disease end points were examined prospectively in Framingham Heart Study participants aged 35 to 75 years, who were followed up to 44 years. The primary outcome was new cardiovascular disease, which included angina pectoris, myocardial infarction, coronary heart disease, or stroke. Analyses compared overweight (BMI [calculated as weight in kilograms divided by the square of height in meters], 25.0-29.9) and obese persons (BMI ≥30) to a referent group of normal-weight persons (BMI, 18.5-24.9). Results The age-adjusted relative risk (RR) for new hypertension was highly associated with overweight status (men: RR, 1.46; women: RR, 1.75). New hypercholesterolemia and diabetes mellitus were less highly associated with excess adiposity. The age-adjusted RR (confidence interval [CI]) for cardiovascular disease was increased among those who were overweight (men: 1.21 [1.05-1.40]; women: 1.20 [1.03-1.41]) and the obese (men: 1.46 [1.20-1.77]; women: 1.64 [1.37-1.98]). High population attributable risks were related to excess weight (BMI ≥25) for the outcomes hypertension (26% men; 28% women), angina pectoris (26% men; 22% women), and coronary heart disease (23% men; 15% women). Conclusions The overweight category is associated with increased relative and population attributable risk for hypertension and cardiovascular sequelae. Interventions to reduce adiposity and avoid excess weight may have large effects on the development of risk factors and cardiovascular disease at an individual and population level.
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Epidemiological evidence shows that diabetes is an independent risk factor for the development of cardiovascular disease.
“Epidemiological evidence shows that diabetes is an independent risk factor for the development of CVD [7,11,12,13,14,15,16]”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [15]
Body mass index is widely used to define overweight and obesity and is a risk factor for cardiovascular disease and type 2 diabetes.
“Body mass index (BMI), a value derived from body weight and height, is widely used to define overweight and obesity and is a risk factor for cardiovascular disease and type 2 diabetes [2, 3].”
In the Framingham Heart Study, compared with normal-weight adults, the multivariable-adjusted relative risks for development of hypertension in long-term follow-up were 1.48 and 1.70 for overweight men and women and 2.23 and 2.63 for obese men and women, respectively.
“Data from the long-standing Framingham Heart Study revealed that compared with normal weight adult men and women, the multivariable-adjusted relative risks for development of hypertension in long-term follow-up were 1.48 and 1.70 for overweight men and women and 2.23 and 2.63 for obese men and women, respectively.53”
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- Authors
- Wilson, P. W. F., D'Agostino, R. B., Sullivan, L., Parise, H., & Kannel, W. B.
- Affiliations
- Boston University (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2002-09-09
- Volume
- 162
- Issue
- 16
- Pages
- 1867
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1564433957
- Cited by
- 22
- References
- 36
- Citations by year
- 2022: 3 · 2019: 1 · 2018: 2 · 2016: 3 · 2015: 3 · 2014: 1 · 2013: 3 · 2012: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (N01-HC-38038)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR/AG 41398)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- overweight, obesity, body mass index, cardiovascular risk, hypertension, hypercholesterolemia, diabetes mellitus, coronary artery disease, stroke, angina pectoris, population attributable risk, Framingham Heart Study
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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