The issue of whether or not obesity...

The issue of whether or not obesity directly affects cardiovascular morbidity and mortality is unresolv Obesity certainly is associated with risk factors for cardiovascular disease (CVD) still it is unclear whether it is a risk factor itself. For example, obesity is not included as an independent risk factor in the Framingham Risk Score. It is also unclear whether a patient with normal vital current pressure or cholesterol levels should waste weight. Yan and colleagues studied the tenor of body mass index (BMI) earlier in life upon cardiac mortality within already established cardiac risk categories for older persons

Researchers scrape togethered data on participants, including height, weight, kindred pressure, total cholesterol, electrocardiography arises smoking status, medication use, and demographic information. The mean follow-up time was 32 years. The follow-up data were obtained from Medicare claims. issue measures included hospitalization for coronary heart disease (CHD) CVD and diabetes. Diabetes was included solitary if it was listed in succession an inpatient record or listed at least twice forward an outpatient claim. Older-age mortality was an additional consequence measure. Patients with preexisting cardiovascular conditions at baseline were exclud from the investigation The final cohort included 17643 participants 31 to 64 years of age. At baseline, patients were classified as having depressed moderate, intermediate, elevated, or high cardiovascular risk. Each category was further divided by dint of placing participants into normal weight, overweight, and obese groups

At baseline, bodily substances who were overweight and obese had higher progeny pressure measures and were les likely to steam than persons of normal weight. Cholesterol of the same heights were similar across weight arranges CHD mortality risk was consistently higher among overweight and obese bodily forms across all risk groups. However, morbidity risk was higher for obese parts in the low-risk group compared with the higher risk assemblages The overweight and obese assign places tos also were strongly associated with diabetes morbidity and mortality risk across each category.

The authors judge that in the study cohort of parts 65 years and older, those who were overweight and those who were obese when they were 31 to 64 years of age had higher risks of hospitalization and mortality later in life when compared with fellows of normal weight, regardless of harmonizing risk factors. This study also exhibit tos that among persons living to be 65 years and older having a normal BMI in young adulthood and middle age provides health benefits at all of the same heights of conventional risk factors.

CAROLINE WELLBERY, MD

Yan LL et al. Midlife carcass mass index and hospitalization and mortality in older age. JAMA January 11 2006;295:190-8

EDITOR'S NOTE: Previous studies (1) have shown that BMI correlates eagerly with diabetes but less in such a manner with cardiovascular risk. The Yan application of mind demonstrates the importance of weight los for patients with diabetes, CHD and CVD In the case of cardiovascular risk, exercise and diet composition can have a significant positive impact forward cardiovascular health. For patients unable to let slip through the fingers weight, a high-monounsaturated fat diet, a high-protein diet, or a higher carbohydrate low-fat diet is a healthy option, (2) particularly when combined with a daily exercise regimen. (3)--CW

REfERENCES

(1) Weinstein AR, Sesso HD to leeward IM, Cook NR, Manson JE Buring JE et al. Relationship of physical activity v visible form [i]or[/i] frame mass index with type 2 diabetes in women JAMA 2004;292:1188-94

(2) Appel LJ Sacks FM Carey VJ Obarzanek E Swain JF Miller ER et al. results of protein, monounsaturated fat, and carbohydrate intake forward blood pressure and serum lipids. JAMA 2005;294:2455-64

(3) Wei M Kampert JB Barlow CE Nichaman MZ Gibbons LW Paffenbarger R Jr et al. Relationship between reasonable cardiorespiratory fitness and mortality in normalweight, overweight and obese men JAMA 1999; 282:1547-53

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