Body mass index and cardiovascular disease in the Asia-Pacific Region: an overview of 33 cohorts involving 310 000 participants
Abstract
BACKGROUND: Few prospective data from the Asia-Pacific region are available relating body mass index (BMI) to the risks of stroke and ischaemic heart disease (IHD). Our objective was to assess the age-, sex-, and region-specific associations of BMI with cardiovascular disease using individual participant data from prospective studies in the Asia-Pacific region. METHODS: Studies were identified from literature searches, proceedings of meetings, and personal communication. All studies had at least 5000 person-years of follow-up. Hazard ratios were calculated from Cox models, stratified by sex and cohort, and adjusted for age at risk and smoking. The first 3 years of follow-up were excluded in order to reduce confounding due to disease at baseline. RESULTS: A total of 33 cohort studies, including 310 283 participants, contributed 2 148 354 person-years of follow-up, during which 3332 stroke and 2073 IHD events were observed. There were continuous positive associations between baseline BMI and the risks of ischaemic stroke, haemorrhagic stroke, and IHD, with each 2 kg/m(2) lower BMI associated a 12% (95% CI: 9, 15%) lower risk of ischaemic stroke, 8% (95% CI: 4, 12%) lower risk in haemorrhagic stroke, and 11% (95% CI: 9, 13%) lower risk of IHD. The strengths of all associations were strongly age dependent, and there was no significant difference between Asian and Australasian cohorts. CONCLUSIONS: This overview provides the most reliable estimates to date of the associations between BMI and cardiovascular disease in the Asia-Pacific region, and the first direct comparisons within the region. Continuous relationships of approximately equal strength are evident in both Asian and Australasian populations. These results indicate considerable potential for cardiovascular disease reduction with population-wide lowering of BMI.
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Observational studies of body-mass index effect sizes have controlled for some potential confounders.
“Observational studies of the effect sizes for body-mass index have controlled for some potential confounders.75–77”
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- Authors
- Asia Pacific Cohort Studies Collaboration
- Affiliations
- University of Auckland (NZ)
- Corresponding author
- Asia Pacific Cohort Studies Collaboration
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2004-07-28
- Volume
- 33
- Issue
- 4
- Pages
- 751-758
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W1591686206
- Semantic Scholar
- 1dce60a9fc8d668d9d49dbfea687d9d25c10a0d8
- Cited by
- 375
- References
- 42
- Citations by year
- 2026: 7 · 2025: 16 · 2024: 8 · 2023: 11 · 2022: 16 · 2021: 25 · 2020: 20 · 2019: 18 · 2018: 18 · 2017: 22 · 2016: 24 · 2015: 17 · 2014: 16 · 2013: 27 · 2012: 26
- FWCI
- 8.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Institutional Repositories DataBase (IRDB) (submittedVersion)
- Funders
- National Institutes of Health
- Health Research Council of New Zealand
- 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 › Oncology › Cancer Risks and Factors
- Keywords
- body mass index, cardiovascular disease, ischemic stroke, hemorrhagic stroke, ischemic heart disease, obesity, Asia-Pacific region, Asian populations, age-specific risk, sex differences, individual patient data meta-analysis
- MeSH terms
- Asia, Australia, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, New Zealand, Prospective Studies, Risk, Body Mass Index, Proportional Hazards Models
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