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”

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.

Download Full-text

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

European Journal of Preventive Cardiology ◽

10.1177/2047487318784365 ◽

2018 ◽

Vol 25 (15) ◽

pp. 1646-1652 ◽

Cited By ~ 14

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.

Download Full-text

Abstract 16546: Pre-Pregnancy Body Mass Index and Risk of Peripartum Cardiomyopathy and Heart Failure in the Years Following Delivery

Circulation ◽

10.1161/circ.142.suppl_3.16546 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Yuliya Mints ◽

Asya Lyass ◽

Michelle D Schmiegelow ◽

morten schou ◽

Gunnar H Gislason ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Body Mass Index ◽

Body Mass ◽

Class Ii ◽

Elevated Risk ◽

Peripartum Cardiomyopathy ◽

Class I ◽

Increased Risk

Introduction: Peripartum cardiomyopathy (PPCM) is a form of systolic heart failure that occurs during pregnancy or in the early post-partum period. Obesity is known to be associated with other forms of heart failure in young adults, however it is unclear if it is also a risk factor for the development of PPCM. Objectives: To investigate the association of body mass index (BMI) with PPCM and heart failure in the years following childbirth. Methods: We conducted a retrospective review of pregnant women in the Danish National Patient Registry between 2004 - 2017. Baseline characteristics and other risk factors were obtained at the first prenatal visit (occurring at 8-11 weeks post-conception). Women were followed until the end of the study period, emigration, or death. Logistic regression was performed, adjusting for age as well as other known risk factors for PPCM. Cox proportional hazards analysis was used to assess the long-term risk of development of heart failure. Results: There were 403,820 pregnancies evaluated in 300,892 women, with an average age of 29 years. The average BMI was 24.4 kg/m2, with 21.6% classified as overweight (BMI 25 - 30 kg/m2) and 12.8% as obese (BMI > 30 kg/m2). The rate of PPCM was 0.1 per 1,000 in normal weight and overweight groups, and 0.3 per 1,000 in the obese women. After adjustment for age, ethnicity, smoking status, gestational diabetes, and presence of preeclampsia, there was a statistically significant increased risk of the development of PPCM up to 6 months after childbirth in patients who had class I (odds ratio [OR] 2.25, 95% CI 1.08-4.68) but not class II/III obesity (OR 1.63, 95% CI 0.60-4.43). This elevated risk persisted during long term follow up, with hazard ratios of 2.43 (95% CI 1.55 - 3.80) in women with class I obesity and 3.20 (95% CI 1.93 - 5.30) in women with class II/III obesity. Conclusions: High early pregnancy BMI is associated with elevated risk of development of peripartum cardiomyopathy even after adjustment for traditional risk factors. This risk of heart failure persists for several years after childbirth.

Download Full-text

Body Size Measures and the Risk of Venous Thrombosis: The Longitudinal Investigation of Thromboembolism Etiology (LITE).

Blood ◽

10.1182/blood.v106.11.1626.1626 ◽

2005 ◽

Vol 106 (11) ◽

pp. 1626-1626

Author(s):

Mary Cushman ◽

Ellen O’Meara ◽

Aaron R. Folsom ◽

Susan R. Heckbert ◽

Neil Zakai ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Body Size ◽

Prospective Study ◽

Venous Thrombosis ◽

Body Mass ◽

Fat Free Mass ◽

Diabetes Status ◽

Increased Risk

Abstract Background: Obesity is associated with an increased risk of venous thrombosis (VT), however little is known about which components of obesity are important. Proposed hypotheses include an association of adipocyte products with hemostatic imbalance, increased body or leg size impairing venous return, increased inflammation, and differences in venous vessel walls in obese persons. We studied the associations of measures of body size and composition with risk of VT in the LITE study. Methods: The LITE is a prospective study evaluating VT risk factors in 21,680 participants aged 45–100, in the Atherosclerosis Risk in Communities (ARIC) study and the Cardiovascular Health Study (CHS). Baseline body size measures were obtained using standardized methods and bioelectric impedance was used to calculate fat and fat-free mass in CHS participants. 729 participants reporting prebaseline VT or baseline warfarin use were excluded. VT events during 12.6 years of follow up were validated by medical record review and classified as idiopathic or secondary. Body size measures were evaluated as risk factors using Cox proportional hazards models, adjusting for age, sex, race and diabetes status. Results: There were 451 VT events during follow-up (1.8 per 1000 person-years); 182 were idiopathic, 315 were deep vein thrombosis (DVT) and 136 pulmonary embolus (PE) +/− DVT. All body size measures were associated with increased risk of VT (table), with height having the weakest association. Those with severe obesity (body-mass index above 40 kg/m2) were at the highest risk, with a nearly 3-fold increased risk compared to those of normal weight. Both fat and fat-free mass were risk factors. Conclusion: In this prospective study, multiple measures of body size, and measures of body composition including fat and non-fat components, were risk factors for VT. Findings suggest a multicausal pathogenesis for obesity-related thrombosis. Further study is required to determine reasons for the association of body size and composition with VT. Relative Risk of VT by Body Size Categories (Quartiles (Q) Except when Noted; lowest quartile is the reference group) Q1 Q2 Q3 Q4 * P <0.05; ** categories are <25, 25–20, 30–40, >40 kg/m2 Body-mass index** 1.0 (reference) 1.3* 2.1* 2.9* Weight 1.0 (ref) 1.2 1.5* 2.5* Height 1.0 (ref) 1.1 1.2 1.4* Waist-hip ratio 1.0 (ref) 1.3 1.5* 1.6* Waist Circumference 1.0 (ref) 1.2 1.3 2.1* Hip Circumference 1.0 (ref) 1.3* 1.5* 2.2* Calf Circumference 1.0 (ref) 1.3 2.0* 2.3* Fat-Free Mass 1.0 (ref) 1.2 1.4 1.9* Fat Mass 1.0 (ref) 1.1 0.8 1.7*

Download Full-text

The Relation of Body Mass Index to Biochemical Parameters and Profile of Heart Failure

Revista de Chimie ◽

10.37358/rc.18.7.6392 ◽

2018 ◽

Vol 69 (7) ◽

pp. 1673-1677

Author(s):

Viviana Aursulesei ◽

Andrei Manta ◽

Razan Al Namat ◽

Monica Hugianu ◽

Angela Maria Moloce ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Body Mass Index ◽

Body Mass ◽

Patient Selection ◽

Biochemical Parameters ◽

Obesity Paradox ◽

Lipid Levels ◽

Randomized Control ◽

Selection Parameters

The bidirectional relation between body mass index (BMI) and heart failure (HF) is complex and not fully understood. The obesity paradox phenomena is controversial and related to patient selection, parameters used for defining abnormal weight, characteristics of HF. Our study sustain the importance of controlling risk factors, in particular plasma glucose, lipid levels, as well as hypertension in patients with HF and BMI over 25 kg/m2. Also, in contrast to the randomized control studies our results can only partially support data related to obesity paradox phenomena.

Download Full-text

Subclinical Cardiac Organ Damage in Patients with Moderate to Severe Psoriasis

Journal of Clinical Medicine ◽

10.3390/jcm10112440 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2440

Author(s):

Anja Linde ◽

Eva Gerdts ◽

Kåre Steinar Tveit ◽

Ester Kringeland ◽

Helga Midtbø

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Treatment Initiation ◽

Severity Index ◽

Organ Damage ◽

Left Ventricular ◽

Infliximab Treatment ◽

Increased Risk ◽

Psoriasis Severity

We explored the association between subclinical cardiac organ damage (OD) with comorbidities and psoriasis severity in 53 psoriasis patients on infliximab treatment (age 47 ± 15 years, 30% women) and 99 controls without psoriasis (age 47 ± 11 years, 28% women). Cardiac OD was assessed by echocardiography as the presence of increased left ventricular (LV) relative wall thickness (RWT), LV hypertrophy or dilated left atrium. Psoriasis severity was graded using the psoriasis area and severity index (PASI). The prevalence of hypertension was 66% in psoriasis vs. 61% in controls (p = 0.54) and cardiac OD seen in 51 and 73%, respectively (p = 0.007). Psoriasis was associated with a lower prevalence of cardiac OD (odds ratio (OR) 0.32, 95% confidence interval (CI) 0.13–0.77, p = 0.01) independent of age, sex, smoking, body mass index, and hypertension. Among psoriasis patients, hypertension was associated with increased risk of subclinical cardiac OD (OR 6.88, 95% CI 1.32–35.98, p = 0.02) independent of age, sex, and body mass index. PASI at treatment initiation was associated with a higher RWT at follow-up, independent of sex, age, and hypertension (β 0.36, p = 0.006) while no association with current PASI was found. In conclusion, cardiac OD was less prevalent in psoriasis patients on infliximab treatment than controls. Hypertension was the major covariable for subclinical cardiac OD in psoriasis.

Download Full-text

POS1383 THE ASSOCIATION BETWEEN BARIATRIC SURGERY AND DUPUYTREN DISEASE: A COHORT STUDY FROM SWEDISH NATIONWIDE HEALTHCARE REGISTRIES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4067 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 974.3-975

Author(s):

T. Burkard ◽

J. Lane ◽

D. Holmberg ◽

A. M. Burden ◽

D. Furniss

Keyword(s):

Bariatric Surgery ◽

Body Mass Index ◽

Weight Loss ◽

Cohort Study ◽

Secondary Care ◽

High Body Mass Index ◽

Null Result ◽

Increased Risk ◽

Dupuytren Disease

Background:Dupuytren disease (DD) is multifactorial, with several genetic and environmental risk factors contributing to disease susceptibility. High body mass index, however, was suggested to be protective of DD.1 The impact of weight loss among obese patients on DD has not been assessed to date.Objectives:To assess the association between bariatric surgery and DD in a secondary care setting.Methods:We performed a propensity score (PS)-matched cohort study using data from Swedish nationwide healthcare registries (patient registry [secondary care], causes of death registry, prescribed drug registry). Patients aged 30-79 years who underwent bariatric surgery between 2006 and 2019 were matched to up to 2 obese bariatric surgery-free patients (called unexposed patients) based on their PS. PS-matching was carried out in risk set sampling to reduce selection bias, within 4 sequential cohort entry blocks to account for time trend biases. The outcome DD was defined as a diagnosis of DD in secondary care or partial or total fasciotomy of wrist or hand. After a 1-year run-in period, patients were followed in an “as-treated” approach. We applied Cox proportional hazard regression to calculate hazard ratios (HR) with 95% confidence intervals (CIs) of incident DD among bariatric surgery patients when compared to obese unexposed patients overall, and in subgroups of age, sex, bariatric surgery type, and by duration of follow-up.Results:A total of 34 959 bariatric surgery patients were PS-matched to 54 769 obese unexposed patients. A total of 71.6% of bariatric surgery patients were women. Bariatric surgery patients had a mean age of 45.5 years and a mean follow-up of 6.9 years. All patient characteristics in obese unexposed patients were highly similar. We observed 126 and 136 severe DD cases among bariatric surgery and obese unexposed patients, respectively. The risk of DD was significantly increased in bariatric surgery patients compared to obese unexposed patients (HR = 1.30, 95% CI 1.02-1.65). The risk of DD was higher in women (HR = 1.36, 95% CI 1.00-1.84) than in men (HR = 1.05, 95% CI 0.70-1.58). Age did not modify the risk of DD among bariatric surgery patients compared to obese unexposed patients. Malabsorptive bariatric surgery yielded an increased risk of DD when compared to obese unexposed patients (HR = 1.33, 95% CI 1.04-1.71), while restrictive bariatric surgery yielded a null result. The risk of DD increased with duration of follow-up (>5 years of follow-up: HR = 1.63, 95% CI 1.14-2.34, null result in earlier follow-up).Conclusion:Our results suggest that substantial weight loss is associated with a latent increased risk of severe DD in an obese population. This observation further strengthens current evidence that high body mass index is protective against DD. The latency of risk increase of DD after bariatric surgery may suggest that slowly adapting metabolic changes may be part of the mechanism of DD emergence.References:[1]Hacquebord JH, Chiu VY, Harness NG. The Risk of Dupuytren Surgery in Obese Individuals. J Hand Surg Am. 2017, 42: 149–55.Acknowledgements:We thank Prof. Dr. Jesper Lagergren (Karolinksa Institutet, Stockholm, Sweden) for hosting Dr. Theresa Burkard for a research stay at the Upper Gastrointestinal Surgery Group and making the data available for use. Furthermore, we thank Dr. Giola Santoni (Karolinksa Institutet, Stockholm, Sweden) for her technical support.Disclosure of Interests:None declared

Download Full-text

Challenging the “jolly fat” hypothesis among older adults: High body mass index predicts increases in depressive symptoms over a 5-year period

Journal of Health Psychology ◽

10.1177/1359105316675209 ◽

2016 ◽

Vol 23 (1) ◽

pp. 48-58 ◽

Cited By ~ 9

Author(s):

Peter Joseph Dearborn ◽

Michael A Robbins ◽

Merrill F Elias

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Depressive Symptoms ◽

Body Mass ◽

Functional Limitations ◽

High Body Mass Index ◽

Obesity Prevalence ◽

Community Based ◽

Objectively Measured

Several investigators have observed lowered risk of depression among obese older adults, coining the “jolly fat” hypothesis. We examined this hypothesis using baseline and a 5-year follow-up body mass index, depressive symptoms, and covariates from 638 community-based older adults. High objectively measured body mass index and functional limitations predicted increased future depressive symptoms. However, symptoms did not predict future body mass index. Self-reported body mass index showed similar associations despite underestimating obesity prevalence. Results did not differ on the basis of gender. Results for this study, the first longitudinal reciprocal risk analysis between objectively measured body mass index and depressive symptoms among older adults, do not support the “jolly fat” hypothesis.

Download Full-text

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

Journal of Global Oncology ◽

10.1200/jgo.18.78402 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 194s-194s ◽

Cited By ~ 1

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.

Download Full-text

Risk factors mediating the effect of body-mass index and waist-to-hip ratio on cardiovascular outcomes: Mendelian randomization analysis

10.1101/2020.07.15.20154096 ◽

2020 ◽

Author(s):

Dipender Gill ◽

Verena Zuber ◽

Jesse Dawson ◽

Jonathan Pearson-Stuttard ◽

Alice R Carter ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Body Mass Index ◽

Body Mass ◽

European Ancestry ◽

Standard Deviation Increase ◽

Waist To Hip Ratio ◽

Increased Risk ◽

Artery Disease

Background: Higher body-mass index (BMI) and waist-to-hip ratio (WHR) increase the risk of cardiovascular disease, but the extent to which this is mediated by blood pressure, diabetes, lipid traits and smoking is not fully understood. Methods: Using consortia and UK Biobank genetic association summary data from 140,595 to 898,130 participants predominantly of European ancestry, MR mediation analysis was performed to investigate the degree to which genetically predicted systolic blood pressure (SBP), diabetes, lipid traits and smoking mediated an effect of genetically predicted BMI and WHR on risk of coronary artery disease (CAD), peripheral artery disease (PAD) and stroke. Results: The 49% (95% confidence interval [CI] 39%-60%) increased risk of CAD conferred per 1-standard deviation increase in genetically predicted BMI attenuated to 34% (95% CI 24%-45%) after adjusting for genetically predicted SBP, to 27% (95% CI 17%-37%) after adjusting for genetically predicted diabetes, to 47% (95% CI 36%-59%) after adjusting for genetically predicted lipids, and to 46% (95% CI 34%-58%) after adjusting for genetically predicted smoking. Adjusting for all the mediators together, the increased risk attenuated to 14% (95% CI 4%-26%). A similar pattern of attenuation was observed when considering genetically predicted WHR as the exposure, and PAD or stroke as the outcomes. Conclusions: Measures to reduce obesity will lower risk of cardiovascular disease primarily by impacting on downstream metabolic risk factors, particularly diabetes and hypertension. Reduction of obesity prevalence alongside control and management of its mediators is likely to be most effective for minimizing the burden of obesity.

Download Full-text

Global Burden and Attributable Risk Factors of Acute Lymphoblastic Leukemia in 204 Countries and Territories from 1990-2019: Estimation Based on Global Burden of Disease Study 2019

10.21203/rs.3.rs-508326/v1 ◽

2021 ◽

Author(s):

Yuefen Hu ◽

Xiuping Zhang ◽

Aijun Zhang ◽

Yu Hou ◽

Yang Liu ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Acute Lymphoblastic Leukemia ◽

Body Mass ◽

Burden Of Disease ◽

Lymphoblastic Leukemia ◽

High Body Mass Index ◽

Attributable Risk ◽

Global Burden ◽

Disease Study

Abstract Purpose: To provide a foundational guideline for policy-makers to efficiently allocate medical resources in the context of population aging and growth, a latest spatial distribution and temporal trend of acute lymphoblastic leukemia (ALL) along with attributable risk factors by sex and age were mapped.Methods: Based on the Global Burden of Disease Study 2019, we calculated the estimated annual percentage change (EAPC) values to quantify temporal trends in morbidity and mortality of ALL. We used applied Spearman rank correlation to estimate the relationship between the EAPC and potential influence factors. The population attributable fraction of potential risk factors for ALL-related disability-adjusted life years (DALYs) were estimated by the comparative risk assessment framework. Results: We found that new ALL cases increased significantly by 129% worldwide, and the age-standardized incidence rate (ASIR) increased by 1.61 percent per year. The proportion of elder patients sharply increased, especially within the higher socio-demographic index (SDI) region. Smoking and high body mass index remained the predominant risk factors for ALL-related mortality. Notably, the contribution of high body mass index presented an increasing trend. Conclusion: The global burden of ALL has steadily increased, especially in middle SDI region. Health measures should be taken into consideration to improve the treatment of elders with ALL due to a great proportion in the higher SDI region. Attention should be paid to the environmental problems caused by industrial development in low SDI areas.

Download Full-text