Chiadi E Ndumele1,2, Laura Cobb3, Mariana Lazo2,4, Natalie A Bello5, Amil Shah6, Vijay Nambi7,8, Roger S Blumenthal9, Gary Gerstenblith9, Scott D Solomon6, Christie M Ballantyne8, Elizabeth Selvin2, Josef Coresh2. 1. Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD; cndumel2@jhmi.edu. 2. Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. 3. Vital Strategies, New York, NY. 4. Department of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. 5. Division of Cardiology, Columbia University Medical Center, New York, NY. 6. Division of Cardiology, Brigham and Women's Hospital, Boston, MA. 7. Michael E. DeBakey Veterans Affairs Hospital, Houston, TX. 8. Division of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX. 9. Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD.
Abstract
BACKGROUND: Excess weight is associated with subclinical myocardial damage, as reflected by high-sensitivity cardiac troponin T (hs-cTnT) concentrations, which portends high heart failure risk. However, the association between weight history and myocardial damage is unknown. METHODS: We evaluated 9062 Atherosclerosis Risk in Communities (ARIC) visit 4 (1996-1999) participants with a body mass index (BMI) ≥ 18.5 kg/m2 and no previous cardiovascular disease. We cross-tabulated visit 4 ("current") BMI categories of normal weight, overweight, and obese with those at visit 1 (1987-1989) and with BMI categories calculated from self-reported weight at age 25 years. Duration of obesity was calculated in years. A cumulative weight measure of "excess BMI-years" was also calculated [product of mean BMI (centered at 25 kg/m2) over all ARIC time points × follow-up duration]. We used logistic regression to estimate associations of weight history metrics with increased hs-cTnT (≥14 ng/L) at visit 4. RESULTS: Overall, 623 individuals (7%) had increased hs-cTnT at visit 4. Within each current BMI category, previous excess weight was associated with increased hs-cTnT, with the strongest associations for those with past and current obesity [odds ratio (OR), 3.85; 95% CI, 2.51-5.90 for obesity at age 25 years and visit 4]. Each 10-year longer obesity duration was associated with increased hs-cTnT (OR, 1.26; 95% CI, 1.17-1.35). Each 100 higher excess BMI-years was also progressively associated with increased hs-cTnT (OR, 1.21; 95% CI, 1.14-1.27). CONCLUSIONS: Previous obesity and greater cumulative weight from young adulthood increase the likelihood of myocardial damage, indicating long-term toxic effects of adiposity on the myocardium and the need for weight maintenance strategies targeting the entire life span.
BACKGROUND: Excess weight is associated with subclinical myocardial damage, as reflected by high-sensitivity cardiac troponin T (hs-cTnT) concentrations, which portends high heart failure risk. However, the association between weight history and myocardial damage is unknown. METHODS: We evaluated 9062 Atherosclerosis Risk in Communities (ARIC) visit 4 (1996-1999) participants with a body mass index (BMI) ≥ 18.5 kg/m2 and no previous cardiovascular disease. We cross-tabulated visit 4 ("current") BMI categories of normal weight, overweight, and obese with those at visit 1 (1987-1989) and with BMI categories calculated from self-reported weight at age 25 years. Duration of obesity was calculated in years. A cumulative weight measure of "excess BMI-years" was also calculated [product of mean BMI (centered at 25 kg/m2) over all ARIC time points × follow-up duration]. We used logistic regression to estimate associations of weight history metrics with increased hs-cTnT (≥14 ng/L) at visit 4. RESULTS: Overall, 623 individuals (7%) had increased hs-cTnT at visit 4. Within each current BMI category, previous excess weight was associated with increased hs-cTnT, with the strongest associations for those with past and current obesity [odds ratio (OR), 3.85; 95% CI, 2.51-5.90 for obesity at age 25 years and visit 4]. Each 10-year longer obesity duration was associated with increased hs-cTnT (OR, 1.26; 95% CI, 1.17-1.35). Each 100 higher excess BMI-years was also progressively associated with increased hs-cTnT (OR, 1.21; 95% CI, 1.14-1.27). CONCLUSIONS: Previous obesity and greater cumulative weight from young adulthood increase the likelihood of myocardial damage, indicating long-term toxic effects of adiposity on the myocardium and the need for weight maintenance strategies targeting the entire life span.
Authors: Christopher R deFilippi; James A de Lemos; Robert H Christenson; John S Gottdiener; Willem J Kop; Min Zhan; Stephen L Seliger Journal: JAMA Date: 2010-11-15 Impact factor: 56.272
Authors: M A Alpert; B E Terry; M Mulekar; M V Cohen; C V Massey; T M Fan; H Panayiotou; V Mukerji Journal: Am J Cardiol Date: 1997-09-15 Impact factor: 2.778
Authors: J L Kraschnewski; J Boan; J Esposito; N E Sherwood; E B Lehman; D K Kephart; C N Sciamanna Journal: Int J Obes (Lond) Date: 2010-05-18 Impact factor: 5.095
Authors: Justin T Saunders; Vijay Nambi; James A de Lemos; Lloyd E Chambless; Salim S Virani; Eric Boerwinkle; Ron C Hoogeveen; Xiaoxi Liu; Brad C Astor; Thomas H Mosley; Aaron R Folsom; Gerardo Heiss; Josef Coresh; Christie M Ballantyne Journal: Circulation Date: 2011-03-21 Impact factor: 29.690
Authors: Chiadi E Ndumele; Josef Coresh; Mariana Lazo; Ron C Hoogeveen; Roger S Blumenthal; Aaron R Folsom; Elizabeth Selvin; Christie M Ballantyne; Vijay Nambi Journal: JACC Heart Fail Date: 2014-10-22 Impact factor: 12.035
Authors: John W McEvoy; Mariana Lazo; Yuan Chen; Lu Shen; Vijay Nambi; Ron C Hoogeveen; Christie M Ballantyne; Roger S Blumenthal; Josef Coresh; Elizabeth Selvin Journal: Int J Cardiol Date: 2015-04-01 Impact factor: 4.164
Authors: Carl J Lavie; Martin A Alpert; Ross Arena; Mandeep R Mehra; Richard V Milani; Hector O Ventura Journal: JACC Heart Fail Date: 2013-04-01 Impact factor: 12.035
Authors: Jared P Reis; Norrina Allen; Erica P Gunderson; Joyce M Lee; Cora E Lewis; Catherine M Loria; Tiffany M Powell-Wiley; Jamal S Rana; Stephen Sidney; Gina Wei; Yuichiro Yano; Kiang Liu Journal: Obesity (Silver Spring) Date: 2015-03-09 Impact factor: 9.298
Authors: Michael Fliotsos; Di Zhao; Vishal N Rao; Chiadi E Ndumele; Eliseo Guallar; Gregory L Burke; Dhanajay Vaidya; Joseph Chris A Delaney; Erin D Michos Journal: J Am Heart Assoc Date: 2018-11-20 Impact factor: 5.501