Nazanin Fekri1,2, Pegah Khaloo2,3, Azra Ramezankhani4, Mohammad Ali Mansournia1, Fereidoun Azizi5, Farzad Hadaegh6. 1. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 2. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 4. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. az.ramezankhani@sbmu.ac.ir. 5. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 6. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. fzhadaegh@endocrine.ac.ir.
Abstract
BACKGROUND: We estimated the average numbers of years lived with and without cardiovascular disease (CVD) in normal weight, overweight, and obese individuals, aged ≥30 years. METHODS: A total of 7529 participants were recruited. The multi-state Markov model was used to obtain hazard ratios (HRs) for three transitions (CVD free to nonfatal CVD, CVD free to all-cause death, and nonfatal CVD to all-cause death) stratified by body mass index (BMI) categories at baseline and adjusted for confounders including sex, age, smoking, family history of premature CVD, education and physical activity. Life expectancies (LEs) were also estimated for each transition stratifying by BMI categories and sex. RESULTS: We found 986 incident cases of nonfatal CVD and 669 overall deaths (236 CVD deaths) after more than 18 years of follow-up. Overweight and obesity were associated with an increased risk of nonfatal CVD (HR, 1.42 (95% confidence interval (CI) 1.21-1.66) and (1.64, 1.37-1.96), respectively), compared with normal weight individuals. Overweight and obesity were also associated with lower risk of mortality without CVD (0.39, 0.20-0.77) and (0.35, 0.14-0.85), respectively. Among those with CVD, overweight compared with normal weight was associated with a lower risk of mortality (0.72, 0.56-0.94). Total LEs for both men and women with overweight and obesity were not significantly different from their normal weight counterparts. Compared with normal weight individuals, men and women with obesity lived 4.1 (CI: -6.3, -1.3) and 4.3 (-6.4, -2.0) fewer years free of CVD; however, they lived 3.9 (2.1, 6.0) and 3.7 (2.1, 5.6) longer years with CVD than their normal weight counterparts, respectively. CONCLUSIONS: We demonstrated that although total LE was not influenced by higher BMI; individuals with overweight and obesity could expect longer longevity after diagnosis of nonfatal CVD. These extra years of life impose financial burden on both patients and the health care system.
BACKGROUND: We estimated the average numbers of years lived with and without cardiovascular disease (CVD) in normal weight, overweight, and obese individuals, aged ≥30 years. METHODS: A total of 7529 participants were recruited. The multi-state Markov model was used to obtain hazard ratios (HRs) for three transitions (CVD free to nonfatal CVD, CVD free to all-cause death, and nonfatal CVD to all-cause death) stratified by body mass index (BMI) categories at baseline and adjusted for confounders including sex, age, smoking, family history of premature CVD, education and physical activity. Life expectancies (LEs) were also estimated for each transition stratifying by BMI categories and sex. RESULTS: We found 986 incident cases of nonfatal CVD and 669 overall deaths (236 CVD deaths) after more than 18 years of follow-up. Overweight and obesity were associated with an increased risk of nonfatal CVD (HR, 1.42 (95% confidence interval (CI) 1.21-1.66) and (1.64, 1.37-1.96), respectively), compared with normal weight individuals. Overweight and obesity were also associated with lower risk of mortality without CVD (0.39, 0.20-0.77) and (0.35, 0.14-0.85), respectively. Among those with CVD, overweight compared with normal weight was associated with a lower risk of mortality (0.72, 0.56-0.94). Total LEs for both men and women with overweight and obesity were not significantly different from their normal weight counterparts. Compared with normal weight individuals, men and women with obesity lived 4.1 (CI: -6.3, -1.3) and 4.3 (-6.4, -2.0) fewer years free of CVD; however, they lived 3.9 (2.1, 6.0) and 3.7 (2.1, 5.6) longer years with CVD than their normal weight counterparts, respectively. CONCLUSIONS: We demonstrated that although total LE was not influenced by higher BMI; individuals with overweight and obesity could expect longer longevity after diagnosis of nonfatal CVD. These extra years of life impose financial burden on both patients and the health care system.
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: Fanny Kilpi; Laura Webber; Abdulrahman Musaigner; Amina Aitsi-Selmi; Tim Marsh; Ketevan Rtveladze; Klim McPherson; Martin Brown Journal: Public Health Nutr Date: 2013-05-03 Impact factor: 4.022