Prediction of First Events of Coronary Heart Disease and Stroke With Consideration of Adiposity
Open accessAbstract
Background— Prediction of coronary heart disease (CHD) and cerebrovascular disease (CeVD) can aid healthcare providers and prevention programs. Previous reports have focused on traditional cardiovascular risk factors; less information has been available on the role of overweight and obesity. Methods and Results— Baseline data from 4780 Framingham Offspring Study adults with up to 24 years of follow-up were used to assess risk for a first CHD event (angina pectoris, myocardial infarction, or cardiac death) alone, first CeVD event (acute brain infarction, transient ischemic attack, and stroke-related death) alone, and CHD and CeVD events combined. Accelerated failure time models were developed for the time of first event to age, sex, cholesterol, high-density lipoprotein cholesterol, diabetes mellitus (DM), systolic blood pressure, smoking status, and body mass index (BMI). Likelihood-ratio tests of statistical significance were used to identify the best-fitting predictive functions. Age, sex, smoking status, systolic blood pressure, ratio of cholesterol to high-density lipoprotein cholesterol, and presence of DM were highly related ( P <0.01 for all) to the development of first CHD events, and all of the above except sex and DM were highly related to the first CeVD event. BMI also significantly predicted the occurrence of CHD ( P =0.05) and CeVD ( P =0.03) in multivariable models adjusting for traditional risk factors. The magnitude of the BMI effect was reduced but remained statistically significant when traditional variables were included in the prediction models. Conclusions— Greater BMI, higher systolic blood pressure, higher ratio of cholesterol to high-density lipoprotein cholesterol, and presence of DM were all predictive of first CHD events, and all but the presence of DM were predictive of first CeVD events. These results suggest that common pathophysiological mechanisms underlie the roles of BMI, DM, and systolic blood pressure as predictors for first CHD and CeVD events.
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Overweight and obesity are independently associated with an increased risk of cardiovascular events, even after accounting for metabolic cardiovascular risk factors linked to excess weight.
“Overweight and obesity are independently associated with an increased risk of cardiovascular events, even after the influence of metabolic cardiovascular risk factors linked to excess weight has been accounted for. 3-6”
From Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (2023) · cites this paper as [6]
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- Authors
- Wilson, P. W. F., Bozeman, S. R., Burton, T. M., Hoaglin, D. C., Ben-Joseph, R., & Pashos, C. L.
- Affiliations
- Emory University (US)
- Venue
- Circulation
- Published
- 2008-07-08
- Volume
- 118
- Issue
- 2
- Pages
- 124-130
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2007287562
- Cited by
- 174
- References
- 19
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 7 · 2023: 8 · 2022: 7 · 2021: 11 · 2020: 5 · 2019: 3 · 2018: 5 · 2017: 13 · 2016: 12 · 2015: 7 · 2014: 7 · 2013: 7 · 2012: 13
- FWCI
- 11.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Sanofi
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- coronary artery disease, stroke, cerebrovascular disease, adiposity, body mass index, cardiovascular risk prediction, accelerated failure time model, Framingham Offspring Study, systolic blood pressure, diabetes mellitus, TC/HDL-C ratio, angina pectoris, myocardial infarction, transient ischemic attack, premature atherosclerosis
- MeSH terms
- Adult, Cholesterol, Coronary Disease, Diabetes Mellitus, Humans, Hypertension, Male, Middle Aged, Predictive Value of Tests, Risk Factors, Body Mass Index, Risk Assessment, Stroke, Adiposity
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.
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