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Observational Study
. 2016 Nov;39(11):653-657.
doi: 10.1002/clc.22576. Epub 2016 Jul 19.

Association Between Body Mass Index and Age of Presentation With Symptomatic Coronary Artery Disease

Syed M Atique  1 , Bruce Shadbolt  2 , Paul Marley  1 , Ahmad Farshid  1   2
Affiliations
Observational Study

Association Between Body Mass Index and Age of Presentation With Symptomatic Coronary Artery Disease

Syed M Atique et al. Clin Cardiol. 2016 Nov.

Abstract

Background: Obesity is increasingly recognized as an important risk factor for coronary artery disease (CAD).

Hypothesis: Patients with increased body mass index (BMI) present at a younger age with symptomatic CAD.

Methods: We analyzed data on 2137 consecutive patients admitted for treatment of CAD proven on angiography from 2010 to 2013, excluding those with prior coronary intervention or bypass surgery.

Results: Mean age was 64.1 ± 12.4 years; 75% were male; 43.6% were overweight (BMI 25-29.9 kg/m2 ) and 31.6% were obese (BMI ≥30 kg/m2 ). Patients with BMI ≥25 kg/m2 compared with <25 kg/m2 were more likely to have diabetes (24.5% vs 13.6%), hypertension (56.2% vs 45.5%), and hyperlipidemia (42.4% vs 31.6%; P < 0.0001 for all). On multivariate analysis adjusted for sex and cardiovascular risk factors, patients in higher BMI categories had lower mean age in a linear and stepwise fashion compared with those with normal BMI (P < 0.0001). For example, compared with patients with normal BMI, those with BMI of 35 to 39.9 kg/m2 were on average 9.2 years younger (P < 0.0001). Multivariate analysis examining the interaction between sex and BMI produced similar results for effect of BMI on age of presentation (P = 0.97 for interaction).

Conclusions: After multivariate adjustment, patients with increased BMI presented at an earlier age with symptomatic CAD compared with patients with normal BMI. Primary prevention efforts in those with increased BMI to reduce risk-factor burden, including evidence-based treatments for weight reduction, promise to reduce risk or delay onset of CAD.

Keywords: Body mass index; Cardiac; Coronary artery disease; Obesity; Preventive cardiology; Risk factors; rehabilitation.

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Figures

Figure 1
Figure 1
Mean age of presentation with symptomatic CAD with 95% CIs in different BMI categories. Abbreviations: BMI, body mass index; CAD, coronary artery disease; CI, confidence interval.
Figure 2
Figure 2
Effect of cardiac risk factors on age of presentation on multivariate analysis. The x‐axis represents the difference between mean age of presentation in patients with and without the risk factor. For example, patients with hypertension were on average approximately 4 years older at presentation compared with those without hypertension. BMI groups are compared with those with a normal BMI (18.5–24.9 kg/m2). Abbreviations: BMI, body mass index.
Figure 3
Figure 3
Multivariate analysis of effect of BMI on age of presentation in men and women in different BMI groups compared with those in the normal BMI group (18.5–24.9 kg/m2). The x‐axis represents the difference between mean age of presentation in men and women in different BMI groups compared with those with a normal BMI (P for interaction = 0.97). Abbreviations: BMI, body mass index.
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References

    1. World Health Organization . Global Status Report on Noncommunicable Diseases 2014. Geneva, Switzerland: World Health Organization; 2014:79–93.
    1. Ogden CL, Carroll MD, Kit BK, et al. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311:806–814. - PMC - PubMed
    1. Hubert HB, Feinleib M, McNamara PM, et al. Obesity as an independent risk factor for cardiovascular disease: a 26‐year follow‐up of participants in the Framingham Heart Study. Circulation. 1983;67:968–977. - PubMed
    1. Wilson PW, D'Agostino RB, Sullivan L, et al. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med. 2002;162:1867–1872. - PubMed
    1. Lu Y, Hajifathalian K, Ezzati M, et al; Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects). Metabolic mediators of the effects of body‐mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1.8 million participants. Lancet . 2014;383:970–983. - PMC - PubMed

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