Long- and Short-term Weight Change and Incident Coronary Heart Disease and Ischemic Stroke: The Atherosclerosis Risk in Communities Study
Open Access
- 3 May 2013
- journal article
- research article
- Published by Oxford University Press (OUP) in American Journal of Epidemiology
- Vol. 178 (2), 239-248
- https://doi.org/10.1093/aje/kws461
Abstract
Weight gain increases the prevalence of obesity, a risk factor for cardiovascular disease. Nevertheless, unintentional weight loss can be a harbinger of health problems. The Atherosclerosis Risk in Communities Study (1987–2009) included 15,792 US adults aged 45–64 years at baseline and was used to compare associations of long-term (30 years) and short-term (3 years) weight change with the risks of coronary heart disease (CHD) and ischemic stroke. Age-, gender-, and race-standardized incidence rates were 4.9 (95% confidence interval (CI): 4.6, 5.2) per 1,000 person-years for CHD and 2.5 (95% CI: 2.3, 2.8) per 1,000 person-years for stroke. After controlling for baseline body mass index and other covariates, long-term weight gain (since age 25 years) of more than 2.7% was associated with elevated CHD risk, and any long-term weight gain was associated with increased stroke risk. Among middle-aged adults, short-term (3-year) weight loss of more than 3% was associated with elevated immediate CHD risk (hazard ratio = 1.46, 95% CI: 1.18, 1.81) and stroke risk (hazard ratio = 1.45, 95% CI: 1.10, 1.92). Risk tended to be larger in adults whose weight loss did not occur through dieting. Avoidance of weight gain between early and middle adulthood can reduce risks of CHD and stroke, but short-term, unintentional weight loss in middle adulthood may be an indicator of immediate elevated risk that has not previously been well recognized.This publication has 34 references indexed in Scilit:
- Excess Body Weight and Incidence of StrokeStroke, 2010
- Is body mass index before middle age related to coronary heart disease risk in later life? Evidence from observational studiesInternational Journal of Obesity, 2009
- Explaining the obesity paradox: cardiovascular risk, weight change, and mortality during long-term follow-up in menEuropean Heart Journal, 2009
- Association of Overweight With Increased Risk of Coronary Heart Disease Partly Independent of Blood Pressure and Cholesterol LevelsA Meta-analysis of 21 Cohort Studies Including More Than 300 000 PersonsArchives of Internal Medicine, 2007
- Body mass index and weight change since 20 years of age and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based StudyInternational Journal of Obesity, 2007
- Changes in risk factors for cardiovascular disease by baseline weight status in young adults who maintain or gain weight over 15 years: the CARDIA studyInternational Journal of Obesity, 2006
- The definition of weight maintenanceInternational Journal of Obesity, 2005
- When Is Baseline Adjustment Useful in Analyses of Change? An Example with Education and Cognitive ChangeAmerican Journal of Epidemiology, 2005
- Comparison of weight in middle age, weight at 18 years, and weight change between, in predicting subsequent 14 year mortality and coronary events: Caerphilly Prospective StudyJournal of Epidemiology and Community Health, 2000
- Community surveillance of coronary heart disease in the Atherosclerosis Risk in Communities (ARIC) Study: Methods and initial two years' experienceJournal of Clinical Epidemiology, 1996