Long-term cardiovascular consequences of obesity: 20-year follow-up of more than 15 000 middle-aged men and women (the Renfrew-Paisley study)
Abstract
AIMS: To examine the long-term cardiovascular consequences of obesity and project the cardiovascular consequences of the recent increase in prevalence of obesity. METHODS AND RESULTS: Between 1972 and 1976, 15 402 individuals aged 45-64, living in two towns in the west of Scotland underwent comprehensive cardiovascular screening. We analysed all deaths and hospitalizations for cardiovascular reasons occurring over the subsequent 20 years according to baseline body mass index (BMI) category. Compared with normal weight individuals (BMI 18.5-24.9), obesity (BMI > or =30) was associated with an increased adjusted risk of coronary heart disease (hazard ratio for death or hospital admission: 1.60, 95% CI 1.45-1.78), heart failure (2.09, 1.68-2.59), stroke (1.41, 1.21-1.65), venous thrombo-embolism (2.29, 1.60-3.30), and atrial fibrillation (1.75, 1.17-2.65). Obesity was associated with nine additional cardiovascular deaths and 36 additional cardiovascular hospital admissions for every 100 affected middle-aged men over the subsequent 20 years (seven deaths and 28 admissions in women). Assuming no change in cardiovascular risk profile and outcomes related to obesity, the increase in prevalence in 1998, when compared with 1972, is projected to lead to an additional four cardiovascular deaths and 14 admissions per 100 middle-aged men and women over the next 20 years. CONCLUSION: Obesity is associated with an increase in a broad range of fatal and non-fatal cardiovascular events. Consideration of only coronary, only fatal, and only first events greatly underestimates the cardiovascular consequences of obesity.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Obesity increases the risk for AF (risk ratio 1.5-1.8), with a progressive increase according to body mass index.
“Obesity increases the risk for AF (risk ratio 1.5-1.8),[288][289][290][291] with a progressive increase according to body mass index.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [289]
Cites
Obesity : Preventing and managing the global epidemic
Akram, D. S., Astrup, A. V., Atinmo, T., Boissin, J.-L., Bray, G. A., Carroll, K. N., Chitson, P., Chen, C., Dietz, W. H., Hill, J. O., et al. (2000) · Research at the University of Copenhagen (University of Copenhagen) · Cited by 12,945 · see citing works
Prevalence and trends in obesity among US adults, 1999–2000
Flegal, K. M. (2002) · JAMA · doi:10.1001/jama.288.14.1723 · Cited by 6,190 · see citing works
Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002.
Hedley, A. A., Ogden, C., Johnson, C. L., Carroll, M., Curtin, L. R., & Flegal, K. (2004) · Journal of the American Medical Association (JAMA) · doi:10.1001/jama.291.23.2847 · Cited by 4,670 · see citing works
Hubert, H. B., Feinleib, M., McNamara, P. M., & Castelli, W. P. (1983) · Circulation · doi:10.1161/01.cir.67.5.968 · Cited by 4,241 · see citing works
Obesity and the risk of heart failure
Kenchaiah, S., Evans, J. C., Levy, D., Wilson, P. W. F., Benjamin, E. J., Larson, M. G., Kannel, W. B., & Vasan, R. S. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa020245 · Cited by 3,093 · see citing works
Kannel, W. B., Wolf, P. A., Benjamin, E. J., & Levy, D. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(98)00583-9 · Cited by 2,033 · see citing works
Stewart, S., Hart, C. L., Hole, D. J., & McMurray, J. J. V. (2002) · The American Journal of Medicine · doi:10.1016/s0002-9343(02)01236-6 · Cited by 1,562 · see citing works
Self-citationObesity and the risk of new-onset atrial fibrillation
Wang, T. J. (2004) · JAMA · doi:10.1001/jama.292.20.2471 · Cited by 1,427 · see citing works
The diagnosis of ischaemic heart pain and intermittent claudication in field surveys.
Rose, G. A. (1962) · Europe PMC (PubMed Central) · Cited by 1,328 · see citing works
He, J., Ogden, L. G., Bazzano, L. A., Vupputuri, S., Loria, C., & Whelton, P. K. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.7.996 · Cited by 1,172 · see citing works
Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death.
Schneider, B. A. (1953) · The Quarterly Review of Biology · doi:10.1086/399926 · Cited by 995 · see citing works
Weight, Weight Change, and Coronary Heart Disease in Women: Risk Within the 'Normal' Weight Range
Willett, W. C. (1995) · JAMA · doi:10.1001/jama.1995.03520300035033 · Cited by 924 · see citing works
Hole, D. J., Watt, G. C. M., Davey-Smith, G., Hart, C., Gillis, C. R., & Hawthorne, V. M. (1996) · BMJ · doi:10.1136/bmj.313.7059.711 · Cited by 910 · see citing works
Self-citation(1948) · Public Health · doi:10.1016/s0033-3506(48)80196-4 · Cited by 802 · see citing works
Prineas, R. J., Crow, R. S., & BLACKBURN, H. W. (1982) · Cited by 707 · see citing works
Cardiovascular Risk Factors and Venous Thromboembolism Incidence
Tsai, A. W., Cushman, M., Rosamond, W. D., Heckbert, S. R., Polak, J. F., & Folsom, A. R. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.10.1182 · Cited by 699 · see citing works
Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study
Stewart, S., Hart, C. L., Hole, D. J., & McMurray, J. J. V. (2001) · Heart · doi:10.1136/heart.86.5.516 · Cited by 661 · see citing works
Self-citationA Prospective Study of Body Mass Index, Weight Change, and Risk of Stroke in Women
Rexrode, K. M. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03540430051032 · Cited by 617 · see citing works
A Prospective Study of Risk Factors for Pulmonary Embolism in Women
Goldhaber, S. Z. (1997) · JAMA · doi:10.1001/jama.1997.03540320044033 · Cited by 603 · see citing works
Body mass index and the risk of stroke in men
Kurth, T., Gaziano, J. M., Berger, K., Kase, C. S., Rexrode, K. M., Cook, N. R., Buring, J. E., & Manson, J. E. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.22.2557 · Cited by 524 · see citing works
Frost, L., Hune, L. J., & Vestergaard, P. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.01.031 · Cited by 430 · see citing works
Obesity: Impact on Cardiovascular Disease
Ades, P. A. (2000) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(11)64633-8 · Cited by 398 · see citing works
Krauss, R. M., Winston, M. C., Fletcher, B. J., & Grundy, S. M. (1998) · Circulation · doi:10.1161/01.cir.98.14.1472 · Cited by 364 · see citing works
Allhoff, P., Laaser, U., & Heinrich, J. (1991) · Springer eBooks · doi:10.1007/978-3-642-95642-3_32 · Cited by 333 · see citing works
Heart failure in the general population of men - morbidity, risk factors and prognosis
Wilhelmsen, L., Rosengren, A., Eriksson, H., & Lappas, G. (2001) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2001.00801.x · Cited by 315 · see citing works
Health Implications of Obesity: An NIH Consensus Development Conference
Burton, B. T., & Foster, W. R. (1985) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(21)03768-8 · Cited by 299 · see citing works
Body Size and Fat Distribution as Predictors of Stroke among US Men
Walker, S. P., Rimm, E. B., Ascherio, A., Kawachi, I. I., Stampfer, M. J., & Willett, W. C. (1996) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a008892 · Cited by 296 · see citing works
The effect of increasing physical activity on voluntary food intake and energy balance.
Woo, R. (1985) · PubMed · Cited by 276 · see citing works
Risk factors for heart failure in the elderly: a prospective community-based study
Chen, Y.-T., Vaccarino, V., Williams, C. S., Butler, J., Berkman, L. F., & Krumholz, H. M. (1999) · The American Journal of Medicine · doi:10.1016/s0002-9343(99)00126-6 · Cited by 256 · see citing works
DEFINITION AND CLASSIFICATION OF CHRONIC BRONCHITIS FOR CLINICAL AND EPIDEMIOLOGICAL PURPOSES
(1965) · The Lancet · doi:10.1016/s0140-6736(65)92953-3 · Cited by 256 · see citing works
Risk factors for pulmonary embolism
Goldhaber, S. Z., Savage, D. D., Garrison, R. J., Castelli, W. P., Kannel, W. B., McNamara, P. M., Gherardi, G. J., & Feinleib, M. (1983) · The American Journal of Medicine · doi:10.1016/0002-9343(83)90805-7 · Cited by 247 · see citing works
Hospitalizations for atrial fibrillation in the general male population: morbidity and risk factors
Wilhelmsen, L., Rosengren, A., & Lappas, G. (2001) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2001.00902.x · Cited by 184 · see citing works
Jw, M. (1954) · The Yale Journal of Biology and Medicine · Cited by 137 · see citing works
Lifestyle factors and risk of cerebrovascular disease in women. The Copenhagen City Heart Study.
Lindenstrøm, E., Boysen, G., & Nyboe, J. (1993) · Stroke · doi:10.1161/01.str.24.10.1468 · Cited by 129 · see citing works
Hawthorne, V. M., Watt, G. C. M., Hart, C., Hole, D. J., Smith, G. D., & Gillis, C. R. (1995) · Scottish Medical Journal · doi:10.1177/003693309504000402 · Cited by 113 · see citing works
Self-citationQuality of Scottish Morbidity Record (SMR) data.
Harley, K., & Jones, C. (1996) · PubMed · Cited by 109 · see citing works
Abbott, R. D., Behrens, G. R., Sharp, D. S., Rodríguez, B. L., Burchfiel, C. M., Ross, G. W., Yano, K., & Curb, J. D. (1994) · Stroke · doi:10.1161/01.str.25.12.2370 · Cited by 104 · see citing works
Waist Circumference, Body Mass Index, and Risk for Stroke in Older People
Dey, D. K., Rothenberg, E. M., Sundh, V., Bosaeus, I. G., & Steen, B. C. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50406.x · Cited by 83 · see citing works
Obesity as a risk factor in coronary artery disease
Rao, S. V., Donahue, M., Pi‐Sunyer, F. X., & Fuster, V. (2001) · American Heart Journal · doi:10.1067/mhj.2001.119419 · Cited by 63 · see citing works
Hart, C., Watt, G. C. M., Smith, G. D., Gillis, C. R., & Hawthorne, V. M. (1997) · International Journal of Epidemiology · doi:10.1093/ije/26.3.508 · Cited by 53 · see citing works
Self-citationAdiposity and stroke among older adults of low socioeconomic status: the Chicago Stroke Study.
DiPietro, L., Ostfeld, A. M., & Rosner, G. L. (1994) · American Journal of Public Health · doi:10.2105/ajph.84.1.14 · Cited by 26 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
Self-citationGuh, D. P., Zhang, W., Bansback, N., Amarsi, Z., Birmingham, C. L., & Anis, A. H. (2009) · BMC Public Health · doi:10.1186/1471-2458-9-88 · Cited by 3,855 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
Self-citationPi-Sunyer, X. (2009) · Postgraduate Medicine · doi:10.3810/pgm.2009.11.2074 · Cited by 1,025 · see citing works
The Long- and Short-Term Impact of Elevated Body Mass Index on the Risk of New Atrial Fibrillation
Tedrow, U. B., Conen, D., Ridker, P. M., Cook, N. R., Koplan, B. A., Manson, J. E., Buring, J. E., & Albert, C. M. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.02.029 · Cited by 500 · see citing works
Atrial fibrillation and obesity—results of a meta-analysis
Wanahita, N., Messerli, F. H., Bangalore, S., Gami, A. S., Somers, V. K., & Steinberg, J. S. (2008) · American Heart Journal · doi:10.1016/j.ahj.2007.10.004 · Cited by 474 · see citing works
Lainscak, M., Blue, L., Clark, A. L., Dahlström, U., Dickstein, K., Ekman, I., McDonagh, T., McMurray, J. J., Ryder, M., Stewart, S., et al. (2011) · European Journal of Heart Failure · doi:10.1093/eurjhf/hfq219 · Cited by 405 · see citing works
Self-citationEffect of Obesity and Overweight on Left Ventricular Diastolic Function
Russo, C., Jin, Z., Homma, S., Rundek, T., Elkind, M. S. V., Sacco, R. L., & Di Tullio, M. R. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.10.042 · Cited by 361 · see citing works
Oro-sensory perception of dietary lipids: new insights into the fat taste transduction
Khan, N. A., & Besnard, P. (2009) · Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids · doi:10.1016/j.bbalip.2009.01.001 · Cited by 111 · see citing works
Obesity-Related Hypertension and the Role of Insulin and Leptin in High-Fat–Fed Rabbits
Lim, K., Burke, S. L., & Head, G. A. (2013) · Hypertension · doi:10.1161/hypertensionaha.111.00705 · Cited by 95 · see citing works
Brevetti, G., Schiano, V., Sirico, G., Giugliano, G., Laurenzano, E., & Chiariello, M. (2006) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2006.02.048 · Cited by 55 · see citing works
Nduhirabandi, F., Huisamen, B., Strijdom, H., Blackhurst, D., & Lochner, A. (2014) · Journal of Pineal Research · doi:10.1111/jpi.12171 · Cited by 48 · see citing works
- Authors
- Murphy, N. F., MacIntyre, K., Stewart, S., Hart, C. L., Hole, D., & McMurray, J. J. V.
- Affiliations
- Western Infirmary (GB)
- University of Glasgow (GB)
- University of South Australia (AU)
- Corresponding author
- Murphy, N.F.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-09-23
- Volume
- 27
- Issue
- 1
- Pages
- 96-106
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2169868628
- Cited by
- 298
- References
- 41
- Citations by year
- 2026: 5 · 2024: 11 · 2023: 8 · 2022: 6 · 2021: 13 · 2020: 16 · 2019: 12 · 2018: 11 · 2017: 16 · 2016: 21 · 2015: 18 · 2014: 21 · 2013: 24 · 2012: 19
- FWCI
- 15.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- British Heart Foundation
- Medical Research Council
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- obesity, cardiovascular disease, body mass index, coronary artery disease, heart failure, stroke, venous thromboembolism, atrial fibrillation, cardiovascular mortality, cardiovascular hospitalization, middle-aged adults, obesity prevalence projections
- MeSH terms
- Cardiovascular Diseases, Cause of Death, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Regression Analysis, Risk Factors, Scotland, Body Mass Index, Prevalence
About these checks
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
