Longer duration of obesity associated with subclinical coronary heart disease

July 16, 2013, The JAMA Network Journals

In a study of adults recruited and followed up over the past 3 decades in the United States, longer duration of overall and abdominal obesity beginning in young adulthood was associated with higher rates of coronary artery calcification, a subclinical predictor of coronary heart disease, according to a study in the July 17 issue of JAMA.

"Subclinical atherosclerosis, identified by the presence of coronary artery calcification (CAC), progresses over time, and predicts the development of coronary heart disease events," according to background information in the article. The degree of overall and abdominal obesity, as reflected by an increased body mass index (BMI) and waist circumference, respectively, are important risk factors for the presence and progression of CAC. "Understanding the influence of the duration of obesity or the presence or progression of atherosclerosis is critical, given the obesity epidemic. With a doubling of obesity rates for adults and a tripling of rates for adolescents during the last 3 decades, younger individuals are experiencing a greater cumulative exposure to excess adiposity during their lifetime. However, few studies have determined the consequences of long-term obesity," the authors write.

Jared P. Reis, Ph.D., of the National Heart, Lung, and Blood Institute, Bethesda, Md., and colleagues conducted a study to investigate whether the duration of overall and abdominal obesity was associated with the presence and 10-year progression of CAC. The study included 3,275 white and black adults 18 to 30 years of age at the beginning of the study period in 1985-1986 who did not initially have overall obesity (BMI ≥30) or abdominal obesity (men; waist circumference [WC] >40.2 inches; women: >34.6 inches) in the multicenter, community-based Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants completed computed tomography scanning for the presence of CAC during the 15-, 20-, or 25-year follow-up examinations. Duration of overall and abdominal obesity was calculated using repeat measurements of BMI and WC, respectively, performed 2, 5, 7, 10, 15, 20, and 25 years after the beginning of the study.

Of the 3,275 eligible participants, 45.7 percent were black and 50.6 percent were women. During followup, 40.4 percent and 41.0 percent developed overall and abdominal obesity, respectively; the average duration of obesity was 13.3 years and 12.2 years for those who developed overall and abdominal obesity, respectively.

Overall, CAC was present in 27.5 percent (n = 902) of participants. The researchers found that the presence and extent of CAC were associated with duration of overall and abdominal obesity. "Approximately 38.2 percent and 39.3 percent of participants with more than 20 years of overall and abdominal obesity, respectively, had CAC compared with 24.9 percent and 24.7 percent of those who never developed overall or abdominal obesity," the researchers write. "Extensive CAC was present in 6.5 percent and 9.0 percent of those with more than 20 years of overall and abdominal obesity, respectively, compared with 5.7 percent and 5.3 percent of those who never developed overall or abdominal obesity, respectively."

The rates of CAC were higher with a longer duration of overall obesity and abdominal obesity. Approximately 25.2 percent and 27.7 percent of those with more than 20 years of overall and abdominal obesity, respectively, experienced progression of CAC compared with 20.2 percent and 19.5 percent of those with 0 years.

"In conclusion, in this study a longer duration of overall and abdominal obesity beginning in young adulthood was associated with CAC and its 10-year progression through middle age independent of the degree of adiposity," the authors write. "These findings suggest that the longer duration of exposure to excess adiposity as a result of the obesity epidemic and an earlier age at onset will have important implications on the future burden of coronary atherosclerosis and potentially on the rates of clinical cardiovascular disease in the United States."

Explore further: Obesity in early 20s curbs chances of reaching middle age

More information: JAMA. 2013;310(3):280-288

Related Stories

Obesity in early 20s curbs chances of reaching middle age

April 29, 2013
Young men who are obese in their early 20s are significantly more likely to develop serious ill health by the time they reach middle age, or not even make it that far, suggests research published in the online journal BMJ ...

Cigarette smoke impacts genes linked to health of heart and lungs

July 10, 2013
New insights into why obese cigarette smokers experience a high risk of heart disease suggest that cigarette smoke affects the activity of hundreds of key genes that both protect the heart and lungs and expose them to damage. ...

Location of body fat can elevate heart disease, cancer risk

July 10, 2013
Individuals with excessive abdominal fat have a greater risk of heart disease and cancer than individuals with a similar body mass index (BMI) who carry their fat in other areas of the body, according to a study published ...

Fitness, obesity independently affect cardiometabolic risk

April 3, 2013
(HealthDay)—Fitness and obesity are independently associated with cardiometabolic (CM) risk, according to a study published in the April 1 issue of The American Journal of Cardiology.

Timing, duration of obesity impact adult diabetes risk

April 5, 2013
(HealthDay)—The likelihood of diabetes in young adulthood is increased for those who are obese as adolescents and those with persistent obesity, compared to those with adult-onset obesity, according to a study published ...

Impaired heart function among obese children may help predict later disease

June 17, 2013
Impaired heart function among obese children and adolescents may be an indicator of future heart disease, a new clinical trial finds. The results were presented Saturday at The Endocrine Society's 95th Annual Meeting in San ...

Recommended for you

Evening hours may pose higher risk for overeating, especially when under stress, study finds

January 16, 2018
Experiments with a small group of overweight men and women have added to evidence that "hunger hormone" levels rise and "satiety (or fullness) hormone" levels decrease in the evening. The findings also suggest that stress ...

Bariatric surgery prolongs lifespan in obese

January 16, 2018
Obese, middle-age men and women who had bariatric surgery have half the death rate of those who had traditional medical treatment over a 10-year period, reports a study that answers questions about the long-term risk of the ...

Sugar-sweetened drinks linked to overweight and obesity in children, adults: Analysis of new studies

December 23, 2017
A new review of the latest evidence on sugar-sweetened beverages (SSBs)- which includes 30 new studies published between 2013 and 2015 (and none of them industry sponsored) - concludes that SSB consumption is associated with ...

As income rises, women get slimmer—but not men

December 21, 2017
(HealthDay)—A comprehensive survey on the widening American waistline finds that as paychecks get bigger, women's average weight tends to drop.

Policy and early intervention can curb obesity rates

December 18, 2017
More information and emphasis on dietary lifestyle changes that prevent obesity, and its comorbidities, have not reduced the rise in obesity in U.S. adults and adolescents, according to a recent study in the New England Journal ...

Warning labels can help reduce soda consumption and obesity, new study suggests

December 15, 2017
Labels that warn people about the risks of drinking soda and other sugar-sweetened beverages can lower obesity and overweight prevalence, suggests a new Johns Hopkins Bloomberg School of Public Health study.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.