scholarly journals Risk of coronary heart disease among cancer survivors with different prediagnosis body mass index

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ahryoung Ko ◽  
Kyuwoong Kim ◽  
Joung Sik Son ◽  
Yu Jin Cho ◽  
Sang Min Park ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cancer Survivors ◽  
Body Mass ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Cancer Site ◽  
Chd Risk

AbstractAssociation between body mass index (BMI) and coronary heart disease (CHD) in cancer survivors is not clearly established. This study analyzed the prediagnosis BMI-CHD association by examining 13,500 cancer survivors identified from the National Health Insurance Service-Health Screening Cohort from January 1, 2004 to December 31, 2009 including the patients who were free of cardiovascular disease at enrollment. The Cox proportional hazards model (adjusted for socioeconomic, health behavior, health status, and medical characteristics) was used for calculating hazard ratios (HR) and 95% confidence intervals (95% CI) for CHD in each prediagnosis BMI category among cancer survivors. Compared to cancer survivors with a prediagnosis BMI between 18.5 and 22.9 kg/m2, those with a prediagnosis BMI of 23.0–24.9 kg/m2 and ≥ 25.0 kg/m2 had significantly higher CHD risk (HR = 1.51; 95% CI: 1.13–2.01 and HR = 1.38; 95% CI: 1.04–1.84, respectively). Cancer survivors with a low prediagnosis BMI (< 18.5 kg/m2) also had significantly higher CHD risk (HR = 1.97; 95% CI: 1.20–3.24) compared to those with a BMI of 18.5–22.9 kg/m2. Similar associations were found after stratifying analyses based on first cancer site and sociodemographic and medical characteristic subgroups. Our study suggests that prediagnosis underweight among patients with cancer is a predictor of CHD risk.

scholarly journals Association of Body Mass Index With Coronary Artery Calcium and Subsequent Cardiovascular Mortality

2020 ◽  
Vol 13 (7) ◽  
Author(s):  
Joseph C. Jensen ◽  
Zeina A. Dardari ◽  
Michael J. Blaha ◽  
Susan White ◽  
Leslee J. Shaw ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Body Mass ◽  
Coronary Artery Calcium ◽  
Odds Ratio ◽  
Cox Proportional Hazards ◽  
Social Security Death Index ◽  
All Cause Mortality

Background: Obesity is associated with higher risk for coronary artery calcium (CAC), but the relationship between body mass index (BMI) and mortality is complex and frequently paradoxical. Methods: We analyzed BMI, CAC, and subsequent mortality using data from the CAC Consortium, a multi-centered cohort of individuals free of established cardiovascular disease (CVD) who underwent CAC testing. Mortality was assessed through linkage to the Social Security Death Index and cause of death from the National Death Index. Multivariable logistic regression was used to determine odds ratios for the association of clinically relevant BMI categories and prevalent CAC. Cox proportional hazards regression modeling was used to determine hazard ratios for coronary heart disease, CVD, and all-cause mortality according to categories of BMI and CAC. Results: Our sample included 36 509 individuals, mean age 54.1 (10.3) years, 34.4% female, median BMI 26.6 (interquartile range, 24.1–30.1), 46.6% had zero CAC, and 10.5% had CAC ≥400. Compared with individuals with normal BMI, the multivariable adjusted odds of CAC >0 were increased in those overweight (odds ratio, 1.13 [95% CI, 1.1–1.2]) and obese (odds ratio, 1.5 [95% CI, 1.4–1.6]). Over a median follow-up of 11.4 years, there were 1550 deaths (4.3%). Compared with normal BMI, obese individuals had a higher risk of coronary heart disease, CVD, and all-cause mortality while overweight individuals, despite a higher odds of CAC, showed no significant increase in mortality. In a sex-stratified analysis, the increase in coronary heart disease, CVD, and all-cause mortality in obese individuals appeared largely limited to men, and there was a lower risk of all-cause mortality in overweight women (hazard ratio, 0.79 [95% CI, 0.63–0.98]). Conclusions: In a large sample undergoing CAC scoring, obesity was associated with a higher risk of CAC and subsequent coronary heart disease, CVD, and all-cause mortality. However, overweight individuals did not have a higher risk of mortality despite a higher risk for CAC.

scholarly journals Trajectories of body mass index and risk for coronary heart disease: A 38-year follow-up study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258395
Author(s):  
Susanna Calling ◽  
Sven-Erik Johansson ◽  
Veronica Milos Nymberg ◽  
Jan Sundquist ◽  
Kristina Sundquist
Keyword(s):  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Life Course ◽  
Body Mass ◽  
Normal Weight ◽  
World Health ◽  
Chd Risk ◽  
Increased Risk ◽  
Overweight Or Obesity

Objective Obesity is a well-known risk factor for coronary heart disease (CHD), but there is little evidence on the effect of long-term trajectories of body mass index (BMI) over the life course. By using repeated assessments, the aim was to study the risk of CHD in adults during 38 years in different trajectories of BMI. Methods A sample of 2129 men and women, aged 20–59 years at baseline, took part in four repeated interviews between 1980 and 2005. Data on BMI, medical history, lifestyle and socioeconomy were collected. Based on the World Health Organization categories of BMI, life course trajectories of stable normal weight, stable overweight, stable obesity, increasing BMI and fluctuating BMI were created. The individuals were followed through national registers for first hospitalization of CHD (389 events) until the end of 2017, and Hazard Ratios (HRs) were calculated, adjusted for age, sex, socioeconomic factors, lifestyle factors and metabolic comorbidities. Results Stable normal weight in all assessments was the reference group. Those who had an increase in BMI from normal weight in the first assessment to overweight or obesity in later assessments had no increased risk of CHD, HR 1.04 (95% CI: 0.70–1.53). The HR for individuals with fluctuating BMI was 1.25 (0.97–1.61), for stable overweight 1.43 (1.03–1.98), for stable obesity 1.50 (0.92–2.55), and for stable overweight or obesity 1.45 (1.07–1.97), after full adjustments. Conclusion Having a stable overweight or obesity throughout adult life was associated with increased CHD risk but changing from normal weight at baseline to overweight or obesity was not associated with increased CHD risk. Prevention of obesity early in life may be particularly important to reduce CHD risk.

Abstract 17260: Body Mass Index, Waist Circumference and the 6-Year Risk of Coronary Heart Disease in 708,544 Thai Men and Women: HCUR Study

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Parinya Chamnan ◽  
Weera Mahawanakul ◽  
Wichai Aekplakorn ◽  
Wannee Nitiyanant ◽  
Prasert Boongird ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Waist Circumference ◽  
Body Mass ◽  
Retrospective Cohort ◽  
Central Obesity ◽  
Men And Women ◽  
Chd Risk ◽  
Different Levels

Introduction: Body mass index (BMI) and waist circumference has been reported to have a positive association with risk of coronary heart disease (CHD) and their optimal levels have been proposed. However, the association was less well described in Asian population. Hypothesis: This study aimed to examine the risk of developing CHD across different levels of BMI and waist circumference in a large retrospective cohort of Thai general population. Methods: This retrospective cohort was derived from the linkage of 2006 health checks data with diagnostic information from electronic health records of 708,544 men and women aged 20 years and above residing in Ubon Ratchathani. We examined the incidence of CHD over 6 years of follow-up in individuals with different levels of BMI defined by the WHO Asia-Pacific cut-offs and central obesity defined as waist circumference higher than half of each individual’s height. Corresponding hazard ratios were computed using Cox proportional hazards regression. Results: Over 3,514,681 person-years, 2,562 CHD cases developed, an overall incidence of 0.73 (95%CI 0.70-0.76) per 1,000 person-years. BMI had a J-shape association with CHD risk, with those with a BMI of 20-22.4 kg/m2 showing the lowest CHD incidence. Waist circumference had a curvilinear relationship with CHD risk, with CHD risk starting to increase after waist circumference of 80 and 85 cm in women and men respectively. CHD risk increased with higher levels of BMI and waist circumference (Table 1). Compared to those with BMI of 20.0-22.9 kg/m 2 and without central obesity, those with BMI higher than 30 kg/m 2 and with and without central obesity had a 1.8 and 2.4 fold increased risk of CHD (Adjusted hazards ratio 1.80 (1.46-2.24) and 2.39 (1.38-4.13) respectively). Conclusions: Different levels of BMI and waist circumference conferred different CHD risk. Change in optimal cut-off of BMI and waist circumference for the Thai population should be considered.

Abstract 11: Prospective Association of Tet2 Mediated Clonal Hematoopoiesis and Heart Failure and Its Subtypes in Postmenopausal Women

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Chuck Eaton ◽  
Laura M Raffield ◽  
Alexander Bick ◽  
Mary Roberts ◽  
Joann E Manson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Postmenopausal Women ◽  
Somatic Mutations ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model

Background: Recent studies have shown that hematopoietic stems cells can undergo clonal expansion secondary to somatic mutations, termed clonal hematopoiesis of indeterminate potential (CHIP). TET2 is frequently mutated in individuals with CHIP and has been associated with coronary heart disease in humans and Heart Failure in mice models. We investigated whether any of the top three somatic mutations ( DNMT3A,TET2, ASXL1) associated with CHIP were prospectively associated with heart failure (HF), heart failure with preserved ejection fraction (HFPEF) or heart failure with reduced ejection fraction (HFrEF) in post menopausal women. Methods: A subcohort of 5214 postmenopausal women in the Women’s Health Intiative were evaluated for CHIP and HF. CHIP was determined at the Broad Institute via whole genome sequencing using the GATK4 MuTect2 somatic variant caller through the NHLBI TOPMed project. Hospitalized heart failure was based upon trained physician record review. HFpEF was defined as an EF > 50% and HFrEF as EF<50% . Cox proportional hazards model were evaluate adjusting for age, race, income, education, cigarette smoking, body mass index, coronary heart disease, atrial fibrillation, diabetes , hypertension, systolic blood pressure, and stroke. Inverse probability weighting was used to account for selection bias associated with the subcohort selection. Results: Of the 5214 postmenopausal women, 597 developed HF, 283 HFpEF and 204 HFrEF. N=408 had CHIP. The top 3 gene mutations associated with CHIP (N=364) were DNMT3A (4.8%), TET2 (1.7%) and ASXL1 (0.5%). Women with CHIP associated with any of the top 3 mutations and with TET2 were associated with HF, HFpEF but not HFrEF. DNMT3A and ASXL1 CHIP mutations were not associated HF, HFpEF or HFrEF (See Table ). Conclusion: CHIP associated with the top 3 somatic mutations and TET2 were prospectively associated with HF and HFpEF consistent with animal models and the concept of HFpEF being associated with pathologic aging. Replication of these findings in other cohorts is warranted.

Body Mass Index, Lipid Metabolism and Estrogens: Their Impact on Coronary Heart Disease

2014 ◽  
Vol 21 (30) ◽  
pp. 3455-3465 ◽  
Author(s):  
G.D. Kolovou ◽  
V. Kolovou ◽  
P.M. Kostakou ◽  
S. Mavrogeni
Keyword(s):  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lipid Metabolism ◽  
Body Mass

Abstract P316: Prehypertension and Incident Acute Coronary Heart Disease in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Stephen P Glasser ◽  
Yulia Khodneva ◽  
Daniel Lackland ◽  
Ronald Prineas ◽  
Monika Safford
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Racial Differences ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Cox Proportional Hazards Models ◽  
Chd Risk ◽  
Regards Study ◽  
Chd Risk Factors

Objective: The independent prognostic value of prehypertension (preHTN) for incident coronary heart disease (CHD) remains unsettled. Using the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study, we examined associations between preHTN and incident acute CHD and CVD death. Methods: REGARDS includes 30,239 black and white community-dwelling adults age 45 and older at baseline. Recruitment occurred from 2003-7, with baseline interviews and in-home data collection for physiologic measures. Follow-up is conducted by telephone every 6 months to detect events and deaths, which are adjudicated by experts. Systolic BP was categorized into <120 mmHg (n=4385), 120-129 mmHg (n=4000), 130-139 (n=2066), and hypertension was categorized into controlled (<140/90 mmHg on treatment) (n=8378), and uncontrolled (>140/90 mmHg) (n=5364). Incident acute CHD was defined as definite or probable myocardial infarction (MI) or acute CHD death. CVD death was defined as acute CHD, stroke, heart failure or other cardiovascular disease related. Cox proportional hazards models estimated the hazard ratios (HR) for incident CHD by BP categories, adjusting for sociodemographics and CHD risk factors. Results: The 23,393 participants free of CHD at baseline were followed for a median of 4.4 years. Mean age was 64.1, 58% were women and 42% were black. There was a significant interaction between sex and BP categories, therefore analyses were stratified by sex. There were 252 non-fatal and fatal acute CHD events among women and 407 among men. Among women, compared with SBP<120 mmHg, BP categories above SBP 120 mmHg were associated with incident CHD (adjusted HR for SBP120-129 mmHg=1.94 {95% CI 1.04-3.62]; SBP 130-139 mmHg=1.92 {0.95-3.87}; controlled HTN=2.16 {1.25-3.75}; uncontrolled HTN=3.25 {1.87-5.65}) in fully adjusted models. Among men, only uncontrolled HTN was associated with incident CHD (HR=1.55 {1.11-2.17}). Conclusion: In this sample, preHTN may be associated with incident CHD among women but not men.

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