Association of Overweight with Increased Risk of Coronary Heart Disease Partly Independent of Blood pressure and Cholesterol Levels - A Meta-Analysis of 21 Cohort Studies Including more than 300,000 Persons

Bogers, R. P., Bemelmans, W. J. E., Hoogenveen, R. T., Boshuizen, H. C., Woodward, M., Knekt, P., van Dam, R. M., Hu, F. B., Visscher, T. L. S., Menotti, A., Thorpe, R. J., Jamrozik, K., Calling, S., Strand, B. H. and Shipley, M. J. (2007) Association of Overweight with Increased Risk of Coronary Heart Disease Partly Independent of Blood pressure and Cholesterol Levels - A Meta-Analysis of 21 Cohort Studies Including more than 300,000 Persons. Archives of Internal Medicine, 167 16: 1720-1728. doi:10.1001/archinte.167.16.1720

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Author Bogers, R. P.
Bemelmans, W. J. E.
Hoogenveen, R. T.
Boshuizen, H. C.
Woodward, M.
Knekt, P.
van Dam, R. M.
Hu, F. B.
Visscher, T. L. S.
Menotti, A.
Thorpe, R. J.
Jamrozik, K.
Calling, S.
Strand, B. H.
Shipley, M. J.
Title Association of Overweight with Increased Risk of Coronary Heart Disease Partly Independent of Blood pressure and Cholesterol Levels - A Meta-Analysis of 21 Cohort Studies Including more than 300,000 Persons
Journal name Archives of Internal Medicine   Check publisher's open access policy
ISSN 0003-9926
2168-6114
Publication date 2007-09-10
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1001/archinte.167.16.1720
Open Access Status File (Publisher version)
Volume 167
Issue 16
Start page 1720
End page 1728
Total pages 9
Place of publication Chicago, IL, United States
Publisher American Medical Association
Collection year 2008
Language eng
Formatted abstract
Background The extent to which moderate overweight (body mass index [BMI], 25.0-29.9 [calculated as weight in kilograms divided by height in meters squared]) and obesity (BMI, ≥ 30.0) are associated with increased risk of coronary heart disease (CHD) through adverse effects on blood pressure and cholesterol levels is unclear, as is the risk of CHD that remains after these mediating effects are considered.

Methods Relative risks (RRs) of CHD associated with moderate overweight and obesity with and without adjustment for blood pressure and cholesterol concentrations were calculated by the members of a collaboration of prospective cohort studies of healthy, mainly white persons and pooled by means of random-effects models (RRs for categories of BMI in 14 cohorts and for continuous BMI in 21 cohorts; total N = 302 296).

Results A total of 18 000 CHD events occurred during follow-up. The age-, sex-, physical activity–, and smoking-adjusted RRs (95% confidence intervals) for moderate overweight and obesity compared with normal weight were 1.32 (1.24-1.40) and 1.81 (1.56-2.10), respectively. Additional adjustment for blood pressure and cholesterol levels reduced the RR to 1.17 (1.11-1.23) for moderate overweight and to 1.49 (1.32-1.67) for obesity. The RR associated with a 5-unit BMI increment was 1.29 (1.22-1.35) before and 1.16 (1.11-1.21) after adjustment for blood pressure and cholesterol levels.

Conclusions Adverse effects of overweight on blood pressure and cholesterol levels could account for about 45% of the increased risk of CHD. Even for moderate overweight, there is a significant increased risk of CHD independent of these traditional risk factors, although confounding (eg, by dietary factors) cannot be completely ruled out.
Keyword Medicine, General & Internal
Body-mass Index
Cardiovascular Mortality
Physical-activity
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: 2008 Higher Education Research Data Collection
School of Public Health Publications
 
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Created: Mon, 18 Feb 2008, 15:01:09 EST