K Dhana1, M A Berghout1, A Peeters2, M A Ikram1,3,4, H Tiemeier1,5, A Hofman1,6, W Nusselder7, M Kavousi1, O H Franco1. 1. Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands. 2. Department of Obesity and Population Health, Baker IDI Heart and Diabetes Institute, Melbourne, Australia. 3. Department of Neurology, Erasmus Medical Center, Rotterdam, the Netherlands. 4. Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands. 5. Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands. 6. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 7. Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands.
Abstract
BACKGROUND: The prevalence of overweight and obesity is increasing globally and is an established risk factor for cardiovascular disease (CVD). Our objective was to evaluate the impact of overweight and obesity on life expectancy and years lived with and without CVD in older adults. METHODS: The study included 6636 individuals (3750 women) aged 55 years and older from the population-based Rotterdam Study. We developed multistate life tables by using prevalence, incidence rate and hazard ratios (HR) for three transitions (free-of-CVD-to-CVD, free-of-CVD-to-death and CVD-to-death), stratifying by the categories of body mass index (BMI) at baseline and adjusting for confounders. RESULTS: During 12 years of follow-up, we observed 1035 incident CVD events and 1902 overall deaths. Obesity was associated with an increased risk of CVD among men (HR 1.57 (95% confidence interval (CI) 1.17, 2.11)) and women (HR 1.49 (95% CI 1.19, 1.86)), compared with normal weight individuals. Overweight and obesity were not associated with mortality in men and women without CVD. Among men with CVD, obesity compared with normal weight, was associated with a lower risk of mortality (HR 0.67 (95% CI 0.49, 0.90)). Overweight and obesity did not influence total life expectancy. However, obesity was associated with 2.6 fewer years (95% CI -4.8, -0.4) lived free from CVD in men and 1.9 (95% CI -3.3, -0.9) in women. Moreover, men and women with obesity lived 2.9 (95% CI 1.1, 4.8) and 1.7 (95% CI 0.6, 2.8) more years suffering from CVD compared with normal weight counterparts. CONCLUSIONS: Obesity had no effect on total life expectancy in older individuals, but increased the risk of having CVD earlier in life and consequently extended the number of years lived with CVD. Owing to increasing prevalence of obesity and improved treatment of CVD, we might expect more individuals living with CVD and for a longer period of time.
BACKGROUND: The prevalence of overweight and obesity is increasing globally and is an established risk factor for cardiovascular disease (CVD). Our objective was to evaluate the impact of overweight and obesity on life expectancy and years lived with and without CVD in older adults. METHODS: The study included 6636 individuals (3750 women) aged 55 years and older from the population-based Rotterdam Study. We developed multistate life tables by using prevalence, incidence rate and hazard ratios (HR) for three transitions (free-of-CVD-to-CVD, free-of-CVD-to-death and CVD-to-death), stratifying by the categories of body mass index (BMI) at baseline and adjusting for confounders. RESULTS: During 12 years of follow-up, we observed 1035 incident CVD events and 1902 overall deaths. Obesity was associated with an increased risk of CVD among men (HR 1.57 (95% confidence interval (CI) 1.17, 2.11)) and women (HR 1.49 (95% CI 1.19, 1.86)), compared with normal weight individuals. Overweight and obesity were not associated with mortality in men and women without CVD. Among men with CVD, obesity compared with normal weight, was associated with a lower risk of mortality (HR 0.67 (95% CI 0.49, 0.90)). Overweight and obesity did not influence total life expectancy. However, obesity was associated with 2.6 fewer years (95% CI -4.8, -0.4) lived free from CVD in men and 1.9 (95% CI -3.3, -0.9) in women. Moreover, men and women with obesity lived 2.9 (95% CI 1.1, 4.8) and 1.7 (95% CI 0.6, 2.8) more years suffering from CVD compared with normal weight counterparts. CONCLUSIONS:Obesity had no effect on total life expectancy in older individuals, but increased the risk of having CVD earlier in life and consequently extended the number of years lived with CVD. Owing to increasing prevalence of obesity and improved treatment of CVD, we might expect more individuals living with CVD and for a longer period of time.
Authors: Amy Berrington de Gonzalez; Patricia Hartge; James R Cerhan; Alan J Flint; Lindsay Hannan; Robert J MacInnis; Steven C Moore; Geoffrey S Tobias; Hoda Anton-Culver; Laura Beane Freeman; W Lawrence Beeson; Sandra L Clipp; Dallas R English; Aaron R Folsom; D Michal Freedman; Graham Giles; Niclas Hakansson; Katherine D Henderson; Judith Hoffman-Bolton; Jane A Hoppin; Karen L Koenig; I-Min Lee; Martha S Linet; Yikyung Park; Gaia Pocobelli; Arthur Schatzkin; Howard D Sesso; Elisabete Weiderpass; Bradley J Willcox; Alicja Wolk; Anne Zeleniuch-Jacquotte; Walter C Willett; Michael J Thun Journal: N Engl J Med Date: 2010-12-02 Impact factor: 91.245
Authors: V P Alberts; M J Bos; P J Koudstaal; A Hofman; J C M Witteman; B H C Stricker; M M B Breteler Journal: Eur J Epidemiol Date: 2010-11 Impact factor: 8.082
Authors: Anna Peeters; Jan J Barendregt; Frans Willekens; Johan P Mackenbach; Abdullah Al Mamun; Luc Bonneux Journal: Ann Intern Med Date: 2003-01-07 Impact factor: 25.391
Authors: Chantal M Koolhaas; Klodian Dhana; Rajna Golubic; Josje D Schoufour; Albert Hofman; Frank J A van Rooij; Oscar H Franco Journal: Am J Epidemiol Date: 2016-03-28 Impact factor: 4.897
Authors: Élvio R Quintal Gouveia; Bruna R Gouveia; Andreas Ihle; Matthias Kliegel; José A Maia; Sergi Bermudez I Badia; Duarte L Freitas Journal: Qual Life Res Date: 2017-01-21 Impact factor: 4.147
Authors: M Arfan Ikram; Guy G O Brusselle; Sarwa Darwish Murad; Cornelia M van Duijn; Oscar H Franco; André Goedegebure; Caroline C W Klaver; Tamar E C Nijsten; Robin P Peeters; Bruno H Stricker; Henning Tiemeier; André G Uitterlinden; Meike W Vernooij; Albert Hofman Journal: Eur J Epidemiol Date: 2017-10-24 Impact factor: 8.082
Authors: Sadiya S Khan; Hongyan Ning; John T Wilkins; Norrina Allen; Mercedes Carnethon; Jarett D Berry; Ranya N Sweis; Donald M Lloyd-Jones Journal: JAMA Cardiol Date: 2018-04-01 Impact factor: 14.676
Authors: Yen How Tan; Jun Pei Lim; Wee Shiong Lim; Fei Gao; Louis L Y Teo; See Hooi Ewe; Bryan M H Keng; Ru San Tan; Woon-Puay Koh; Angela S Koh Journal: Obes Facts Date: 2022-03-04 Impact factor: 4.807
Authors: Leopold Ndemnge Aminde; Noah Takah; Calypse Ngwasiri; Jean Jacques Noubiap; Maxime Tindong; Anastase Dzudie; J Lennert Veerman Journal: BMC Public Health Date: 2017-06-05 Impact factor: 3.295
Authors: Hanna Lagström; Sari Stenholm; Tasnime Akbaraly; Jaana Pentti; Jussi Vahtera; Mika Kivimäki; Jenny Head Journal: Am J Clin Nutr Date: 2020-04-01 Impact factor: 7.045
Authors: Bruna R Gouveia; Andreas Ihle; Matthias Kliegel; Duarte L Freitas; Élvio R Gouveia Journal: Prim Health Care Res Dev Date: 2018-09-13 Impact factor: 1.458