scholarly journals Physical activity modifies the risk of atrial fibrillation in obese individuals: The HUNT3 study

2018 ◽  
Vol 25 (15) ◽  
pp. 1646-1652 ◽  
Author(s):  
Lars E Garnvik ◽  
Vegard Malmo ◽  
Imre Janszky ◽  
Ulrik Wisløff ◽  
Jan P Loennechen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Body Mass ◽  
High Body Mass Index ◽  
Overweight And Obesity ◽  
Hazard Ratio ◽  
Increased Risk

Background Atrial fibrillation is the most common heart rhythm disorder, and high body mass index is a well-established risk factor for atrial fibrillation. The objective of this study was to examine the associations of physical activity and body mass index and risk of atrial fibrillation, and the modifying role of physical activity on the association between body mass index and atrial fibrillation. Design The design was a prospective cohort study. Methods This study followed 43,602 men and women from the HUNT3 study in 2006–2008 until first atrial fibrillation diagnosis or end of follow-up in 2015. Atrial fibrillation diagnoses were collected from hospital registers and validated by medical doctors. Cox proportional hazard regression analysis was performed to assess the association between physical activity, body mass index and atrial fibrillation. Results During a mean follow-up of 8.1 years (352,770 person-years), 1459 cases of atrial fibrillation were detected (4.1 events per 1000 person-years). Increasing levels of physical activity were associated with gradually lower risk of atrial fibrillation ( p trend 0.069). Overweight and obesity were associated with an 18% (hazard ratio 1.18, 95% confidence interval 1.03–1.35) and 59% (hazard ratio 1.59, 95% confidence interval 1.37–1.84) increased risk of atrial fibrillation, respectively. High levels of physical activity attenuated some of the higher atrial fibrillation risk in obese individuals (hazard ratio 1.53, 95% confidence interval 1.03–2.28 in active and 1.96, 95% confidence interval 1.44–2.67 in inactive) compared to normal weight active individuals. Conclusion Overweight and obesity were associated with increased risk of atrial fibrillation. Physical activity offsets some, but not all, atrial fibrillation risk associated with obesity.

scholarly journals The Future Excess Fraction of Cancer Attributable to High Body Mass Index in Australia

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 194s-194s ◽  
Author(s):  
R. Carey ◽  
R. Norman ◽  
D. Whiteman ◽  
A. Reid ◽  
R. Neale ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Adult Population ◽  
Significant Proportion ◽  
High Body Mass Index ◽  
Overweight And Obesity ◽  
High Body ◽  
Increased Risk ◽  
The Future ◽  
Future Burden

Background: High body mass index (BMI > 25 kg/m2) has been found to be associated with an increased risk of many cancers, including cancers of the colon and rectum, liver, and pancreas. Aim: This study aimed to estimate the future burden of cancer resulting from current levels of overweight and obesity in Australia. Methods: The future excess fraction method was used to estimate the future burden of cancer among the proportion of the Australian adult population who were overweight or obese in 2016. Calculations were conducted for 13 cancer types, including cancers of the colon, rectum, kidney, and liver. Results: The cohort of 18.7 million adult Australians in 2016 will develop ∼7.6 million cancers over their lifetime. Of these, ∼402,500 cancers (5.3%) will be attributable to current levels of overweight and obese. The majority of these will be postmenopausal breast cancers (n = 72,300), kidney cancers (n = 59,200), and colon cancers (n = 55,100). More than a quarter of future endometrial cancers (30.3%) and esophageal adenocarcinomas (35.8%) will be attributable to high body mass index. Conclusion: A significant proportion of future cancers will result from current levels of high body mass index. Our estimates are not directly comparable to past estimates of the burden from overweight and obesity because they describe different quantities - future cancers in currently exposed vs current cancers due to past exposures. The results of this study provide us with relevant up-to-date information about how many cancers in Australia could be prevented.

P3781Prognostic impact of body mass index on mortality and its causes in patients with atrial fibrillation: the Fushimi AF Registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y An ◽  
M Iguchi ◽  
M Ishii ◽  
N Masunaga ◽  
Y Aono ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Obesity Paradox ◽  
Chronic Obstructive ◽  
Inverse Association ◽  
Community Based ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Obesity has been shown to be related to an increased risk for incidence and progression of atrial fibrillation (AF). Meanwhile, the inverse association between body mass index (BMI) and mortality, so-called “obesity paradox”, is well-known among patients with AF, as well as other cardiovascular diseases. However, data regarding the relationship between BMI and specific causes of death in AF patients remain scarce. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto. The inclusion criterion for the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time. We started to enroll patients from March 2011, and baseline characteristics including BMI and follow-up data were available for 3,805 patients by the end of November 2018. Patients were categorized into 3 groups depending on the BMI value; underweight (<18.5 kg/m2; 419 patients), normal (18.5 to <25.0 kg/m2; 2,283 patients), overweight (≤25.0 kg/m2; 1,103 patients). Results In the entire population, the mean BMI level was 23.1±4.0 kg/m2. The lower BMI was associated with higher age (78.5±10.3, 74.0±10.3, and 71.3±10.9 years in Underweight, Normal, and Overweight, respectively; p<0.001) and with higher prevalence of various comorbidities and CHA2DS2-VASc scores (3.83±1.67, 3.43±1.70, and 3.29±1.64, p<0.001). Oral anticoagulants were less frequently prescribed in those with lower BMI (46%, 56%, and 58%, p<0.001). During a median follow-up of 1,464 days (interquartile range: 727–2,228 days), all-cause mortality was lower in accordance with higher BMI (14.3, 5.3, and 3.5 per 100 person-years, respectively; p<0.001). The proportion of infection as a cause of death was prominently higher in the Underweight group than the others (25.7%, 16.7%, and 13.4%, p<0.001) (Figure A). Furthermore, the mortality due to infection was consistently higher in Underweight than in the others in any of the age subgroups (Figure B). Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the BMI value for mortality, adjusted by age, sex, chronic kidney disease, anemia, chronic obstructive pulmonary disease, history of major bleeding, and other components of CHA2DS2-VASc score. Higher BMI was related to lower all-cause mortality (per 5 kg/m2 increase: HR 0.71 [95% CIs 0.63–0.78], p<0.001), and also lower mortality due to infection (per 5 kg/m2 increase: HR 0.48 [95% CIs 0.37–0.61], p<0.001). Figure 1 Conclusions In a Japanese community-based AF cohort, obesity paradox was also observed on all-cause mortality. In particular, lower BMI was strongly associated with the mortality due to infection regardless of age. Acknowledgement/Funding Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi-Sankyo, Novartis Pharma, MSD, Sanofi-Avent

scholarly journals High prevalence of cardiac dysfunction or overt heart failure in 71-year-old men: A 21-year follow-up of “The Study of men born in 1943”

2019 ◽  
Vol 27 (7) ◽  
pp. 717-725 ◽  
Author(s):  
Xiaojing Chen ◽  
Erik Thunström ◽  
Per-Olof Hansson ◽  
Annika Rosengren ◽  
Zacharias Mandalenakis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Body Mass Index ◽  
Random Sample ◽  
Body Mass ◽  
Cardiac Dysfunction ◽  
High Body Mass Index ◽  
Increased Risk ◽  
Old Men

Background Knowledge about long-term risk factors and the prevalence of heart failure stages in general population is limited. We aimed to study the prevalence of cardiac dysfunction and heart failure in 71-year-old men and potential risk factors in the past two decades. Design This research was based on a randomized selected population study with longitudinal follow-up. Methods A random sample of men born in 1943 in Gothenburg, Sweden were examined in 1993 (at 50 years of age) and re-examined 21 years later in 2014 (at 71 years of age). Cardiac dysfunction or heart failure was classified into four stages (A–D) according to American Heart Association/American College of Cardiology guidelines on heart failure. Results Of the 798 men examined in 1993 (overall cohort), 535 (67%) were re-examined in 2014 (echo cohort). In the echo cohort 122 (23%) men had normal cardiac function, 135 (25%) were at stage A, 207 (39%) men were at stage B, 66 (12%) men were at stage C, and five (1%) men were at stage D. Multivariable logistic regression demonstrated that elevated body mass index at 50 years old was the only independent risk factor for developing heart failure/cardiac dysfunction during the subsequent 21 years. For each unit (1 kg/m2) of increased body mass index, the odds ratio for stages C/D heart failure vs no heart failure/stage A increased by 1.20 (95% confidence interval, 1.11–1.31, p < 0.001), after adjustment for smoking, sedentary life style, systolic blood pressure, diabetes, and hyperlipidemia. Conclusion In a random sample of men at 71 years of age, half presented with either cardiac dysfunction or clinical heart failure. High body mass index was associated with an increased risk for developing cardiac dysfunction or heart failure over a 21-year period.

Impact of body mass index on outcomes in European patients with atrial fibrillation: the ESC EHRA EORP Atrial Fibrillation General Long-Term registry (AFGen LT)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Boriani ◽  
M Proietti ◽  
C Laroche ◽  
L Fauchier ◽  
F Marin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Large Cohort ◽  
Funding Source ◽  
Increased Risk ◽  
Underweight Patients ◽  
The Impact

Abstract Introduction The impact of body mass index (BMI) on outcomes in patients with atrial fibrillation (AF) has been largely debated. Aims To describe the relationship between BMI categories and clinical outcomes in a large cohort of European AF patients. Methods We included all AF patients with available baseline BMI and creatinine clearance and 1-year follow-up data enrolled in the EORP-AF General Long-Term Registry. Outcomes considered were: i) a composite of any thromboembolic event (TE)/acute coronary syndrome (ACS)/cardiovascular (CV) death; ii) CV death; iii) all-cause death. Results A total of 7,759 patients were included in this analysis. Of these, 55 (0.7%) were underweight, 2,074 (26.7%) were normal weight, 3,170 (40.9%) were overweight, 1,703 (21.9%) were obese and 757 (9.8%) were severe obese. Mean age was progressively lower across the categories (p&lt;0.0001), with proportion of patients aged≥75 years also progressively lower (52.7% in underweight to 19.4% in severe obese patients; p&lt;0.001). Both underweight (41.8%) and severe obese (25.0%) patients were more likely symptomatic (p&lt;0.001). Mean CHA2DS2-VASc score was higher in underweight patients (p=0.0325). Use of any oral anticoagulant therapy was progressively higher across the BMI categories (p&lt;0.001). At 1-year follow-up the rate of all outcomes considered were highest for underweight patients and lowest in severe obese [Figure 1]. On univariate Cox regression analysis, being underweight was consistently associated to a higher risk for all outcomes, while increasing of weight categories was associated with progressively lower risk for adverse outcomes. After full adjustment with clinical and pharmacological characteristics, no effect of higher BMI classes was found for any outcome, but an independent association with an increased risk of CV death and all-cause death was seen for underweight patients (Table 1). Conclusions In a large cohort of European AF patients a progressively lower rate of outcomes was found across increasing BMI classes. After full adjustments, no significant association was found between the higher BMI classes and outcomes. Underweight was associated with an increased risk for CV death and all-cause death. Figure 1. Outcomes at 1-year Follow-up Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Since the start of EORP programme, several companies have supported it with unrestricted grants

636 Associations among sleep, physical activity and high body mass index in youth: Age differences

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A249-A249
Author(s):  
Xiaopeng Ji ◽  
Lauren Covington ◽  
Janeese Brownlow
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Sleep Duration ◽  
Body Mass ◽  
Age Groups ◽  
High Body Mass Index ◽  
Overweight And Obesity ◽  
Regular Physical Activity ◽  
High Body ◽  
High Bmi

Abstract Introduction Short sleep duration is associated with overweight and obesity. Less clear is how sleep regularity and physical activity interact with sleep duration in predicting overweight across adolescent stages. This study examined interactions between (1) sleep duration and regularity, and (2) sleep duration and physical activity on overweight in preadolescents (10–11 years), early (12–14), and middle (15–17 years) adolescents. Methods Using the National Survey of Children’s Health 2017–2018 dataset, we included youth with sleep, physical activity and overweight data available (n=25,875) in the analyses. Parents reported their children’s sleep duration, sleep regularity and physical activity (&gt;60 min/day) frequency per week. High Body Mass Index (BMI, ≥85th percentile) for age and sex indicated overweight/obesity. Accounting for complex survey design and covariates (age, sex, race, poverty, and resilience), separate logistic regression models (STATA 16.0) estimated the associations in preadolescents, early and middle adolescents. Results Preadolescents had the highest odds of high BMI compared to other age groups (OR= 0.64 and 0.78, p&lt;0.001). Every hour increase in sleep duration was associated with 4–18% decrease in the odds of having high BMI, with the highest magnitude shown in preadolescents (OR=0.82, p&lt;0.001), followed by adolescents aged 12–14 (OR=0.89, p&lt;0.001) and 15–17 years old (OR=0.96, p=0.04). For preadolescents, irregular sleep (OR=1.41, p&lt;0.001) and physical activity (OR=0.83, p=0.03) modified the association between sleep duration and BMI. Specifically, the association was attenuated or even reversed among irregular sleepers (OR=1.09, p=0.27) compared with regular sleepers (OR=0.77, p&lt;0.001). Preadolescents with regular physical activity (≥4 days/week) showed stronger associations (OR=0.74, p&lt;0.001) between sleep duration and BMI than their counterparts (OR=0.89, p=0.01). Sleep regularity was not associated with BMI nor a modifier in other age groups. Although there was no interaction with sleep duration, regular physical activity was independently associated with decreased odds of having high BMI (OR=0.62, p&lt;0.001) in early and middle adolescents. Conclusion The relationship between lifestyle factors (i.e., sleep duration and physical activity) and BMI varies by age groups. Sufficient sleep duration, regular bedtimes and physical activity represent resilience factors against overweight/obesity, especially in preadolescents who are at greater risk for high BMI. Support (if any) N/A

scholarly journals Associations Between Physical Activity and Incident Hypertension Across Strata of Body Mass Index: A Prospective Investigation in a Large Cohort of French Women

2020 ◽  
Vol 9 (23) ◽  
Author(s):  
Conor‐James MacDonald ◽  
Anne‐Laure Madika ◽  
Martin Lajous ◽  
Nasser Laouali ◽  
Fanny Artaud ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Mass ◽  
High Body Mass Index ◽  
Healthy Weight ◽  
Cox Models ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Diet History Questionnaire ◽  
Diet History

Background High body mass index (BMI) and low physical activity are associated with increased risk of hypertension. Few studies have assessed their joint impact or the relation of physical activity and hypertension among individuals within a healthy BMI range. The objective of this study was to investigate the associations between physical activity and hypertension across strata of BMI. Methods and Results We used data from the E3N (Etude Epidémiologique de femmes de la Mutuelle Générale de l´Education) cohort, a French prospective study of women aged 40 to 65 years. We included participants who completed a diet history questionnaire and who did not have prevalent hypertension at baseline, resulting in a total of 41 607 women. Questionnaires assessed time spent undertaking various types of physical activity. Hypertension cases were self‐reported. Cox models were used to calculate hazard ratios (HRs) for physical activity. Associations were assessed over strata of BMI. Among the 41 607 included women, 10 182 cases of hypertension were identified in an average follow‐up time of 14.5 years. Total physical activity was associated with a lower hypertension risk in women within the high‐normal BMI range (BMI, 22.5–24.9) (HR Quartile 1–Quartile 4 , 0.89; 95% CI, 0.79–0.99). An inverse relationship was observed between sports (HR sports >2 hours , 0.87; 95% CI, 0.83–0.93), walking (HR walk >6.5 hours , 0.94; 95% CI, 0.90–1.00), and gardening (HR gardening >2.5 hours , 0.94; 95% CI, 0.89–0.99). Sports were associated with a reduced risk of hypertension in women with a healthy weight, but evidence was weaker in overweight/obese or underweight women. Conclusions Women with a healthy weight were those who could benefit most from practicing sports, and sports provided the largest risk reduction compared with other types of activity.

scholarly journals Genetically-determined body mass index and the risk of atrial fibrillation progression in men and women

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246907
Author(s):  
J. E. Siland ◽  
B. O. Nguyen ◽  
R. R. de With ◽  
I. C. Van Gelder ◽  
P. van der Harst ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Genetic Risk Score ◽  
European Ancestry ◽  
Supporting Evidence ◽  
Men And Women ◽  
Increased Risk ◽  
Genetically Determined

Aims Limited causal evidence is available on the relationship between body mass index (BMI) and atrial fibrillation (AF) progression. Sex differences have been noted and may be relevant for AF progression. We investigated the association between the BMI Genetic Risk Score (GRS) and AF progression in men and women of the Groningen Genetic Atrial Fibrillation (GGAF) cohort. Methods and results The GGAF cohort (n = 2207) is a composite of 5 prospective cohorts with individuals of European ancestry. AF patients with genetic information, with at least 12 months follow-up and AF progression data were included. AF progression was defined as progression from paroxysmal to persistent/permanent AF, or persistent to permanent AF. A BMI GRS was constructed of genetic variants associated with BMI. Univariate and multivariate Cox proportional hazard regression analyses were performed in the total population and in men and women, separately. During a median follow-up of 34 [interquartile range 19–48] months 630 AF patients (mean age 62±11, 36% women, BMI of 28±5) were analyzed, and men and women developed similar AF progression rates (respectively 6.5% versus 6.1%). The BMI GRS was not associated with AF progression either as a continuous variable or in tertiles in the overall population. However, the BMI GRS was associated with the tertile of the highest BMI GRS in women (n = 225), also after multivariable adjustments of clinical risk factors (Hazard ratio 2.611 (95% confidence interval 1.151–5.924) p = 0.022). Conclusions Genetically-determined BMI is only associated with women at risk of AF progression. The results may be supporting evidence for a causal link between observed BMI and AF progression in women. We emphasize the need for further investigation of genetically determined BMI and observed BMI to optimize AF management in women with increased risk for AF progression.

scholarly journals Higher body mass index at ages 16 to 20 years is associated with increased risk of a multiple sclerosis diagnosis in subsequent adulthood among men

2020 ◽  
Vol 27 (1) ◽  
pp. 147-150 ◽  
Author(s):  
Yin Xu ◽  
Ayako Hiyoshi ◽  
Judith S Brand ◽  
Kelsi A Smith ◽  
Shahram Bahmanyar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Physical Fitness ◽  
Body Mass ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Military Conscription ◽  
Increased Risk ◽  
Multiple Sclerosis Diagnosis

Background: Evidence for the association between body mass index (BMI) and multiple sclerosis (MS) among men remains mixed. Objective and methods: Swedish military conscription and other registers identified MS after age of 20 years and BMI at ages 16–20 years ( N = 744,548). Results: Each unit (kg/m2) BMI increase was associated with greater MS risk (hazard ratio and 95% confidence interval = 1.034, 1.016–1.053), independent of physical fitness (1.021, 1.001–1.042). Categorised, overweight and obesity were associated with statistically significant raised MS risk compared to normal weight, but not after adjustment for physical fitness. Conclusion: MS risk rises with increasing BMI, across the entire BMI range.

scholarly journals Impact of body mass index on mortality and hospitalisation of patients with atrial fibrillation

2018 ◽  
Vol 17 (7) ◽  
pp. 627-636 ◽  
Author(s):  
Jocasta Ball ◽  
Maja-Lisa Løchen ◽  
Melinda J Carrington ◽  
Joshua F Wiley ◽  
Simon Stewart
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Body Mass ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Chronic Atrial Fibrillation ◽  
Normal Body Mass Index

Background: Atrial fibrillation represents a substantial clinical and public health issue. The definitive impact of body mass index on prognosis of patients with chronic (persistent or permanent) atrial fibrillation remains undetermined. Aim: The purpose of this study was to investigate the association of body mass index with health outcomes (mortality and re-hospitalisation) of patients with chronic atrial fibrillation. Methods: Using data from the Standard versus Atrial Fibrillation spEcific managemenT strategY (SAFETY) trial (a randomised controlled trial of home-based, atrial fibrillation-specific disease management), we performed post-hoc analyses of mortality and re-hospitalisation outcomes during minimum 24-month follow-up according to baseline body mass index profile. Results: Of 297 participants (mean age 71±11 years, 47% female, mean body mass index 29.6±6.7 kg/m2), 35.0% of participants were overweight (body mass index 25.0–29.9 kg/m2) and 43.1% were obese (body mass index≥30 kg/m2). During follow-up, n=42 died including 16/65 (24.6%) classified as normal body mass index, 16/104 (15.4%) classified as overweight and 10/128 (7.8%) classified as obese. Increasing body mass index was not associated with increased mortality but was associated with re-hospitalisation due to cardiovascular disease with greater length-of-stay (odds ratio 1.05; 95% confidence interval 1.00–1.09, p=0.032). Obese individuals experienced increased unplanned admissions compared to overweight individuals (incidence rate ratio 0.71; 95% confidence interval 0.53–0.96, p=0.028), and increased cardiovascular-related (incidence rate ratio 0.58; 95% confidence interval 0.39–0.86, p=0.007) and all-cause admissions (incidence rate ratio 0.63; 95% confidence interval 0.45–0.89, p=0.008) compared to those classified as normal body mass index. Conclusion: Overweight and obesity were not associated with survival in patients with chronic atrial fibrillation but were associated with more frequent hospital care and prolonged stay.

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