Body mass index and vascular disease in men aged 65 years and over: HIMS (Health In Men Study)

Lacey, Ben, Yeap, Bu B., Golledge, Jonathan, Lewington, Sarah, Mccaul, Kieran A., Norman, Paul E., Flicker, Leon, Almeida, Osvaldo P., and Hankey, Graeme J. (2017) Body mass index and vascular disease in men aged 65 years and over: HIMS (Health In Men Study). Journal of the American Heart Association, 6 (12).

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Abstract

Background-Understanding the relationship between body mass index (BMI) and vascular disease at older age has become increasingly important in the many countries where both average age and BMI are rising.

Methods and Results-In this prospective cohort study, 12 203 men (aged >= 65) were recruited in 1996-1999 from the general population in Perth, Australia. To limit reverse causality, analyses excluded those with past vascular disease and the first 4 years of follow-up. During a further 8 (SD3) years of follow-up, there were 1136 first-ever major vascular events (nonfatal myocardial infarction, nonfatal stroke, or death from any vascular cause). Cox regression (adjusted for age, education, and smoking) related BMI at recruitment to incidence of major vascular events. At ages 65 to 94, the lowest risk of major vascular events was at approximate to 22.5 to 25 kg/m(2). In the higher BMI range (>= 25 kg/m(2)), 5 kg/m(2) higher BMI was associated with 33% higher risk of major vascular events (hazard ratio, 1.33 [95% confidence interval, 1.18-1.49]): 24% higher risk of ischemic heart disease (1.24 [1.06-1.46]); 34% higher risk of stroke (1.34 [1.11-1.63]); and 78% higher risk of other vascular death (1.78 [1.32-2.41]). In the lower BMI range, there were fewer events and no strong evidence of an association (hazard ratio per 5 kg/m(2) higher BMI, 0.82 [95% confidence interval, 0.61-1.12]).

Conclusions-In this population of older men, risk of major vascular events was lowest at approximate to 22.5 to 25 kg/m(2). Above this range, BMI was strongly related to incidence of major vascular events, with each 5 kg/m(2) higher BMI associated with approximate to 30% higher risk.

Item ID: 52227
Item Type: Article (Research - C1)
ISSN: 2047-9980
Keywords: adiposity, body mass index, epidemiology, ischemic heart disease, stroke, vascular disease
Additional Information:

© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Funders: Sylvia and Charles Viertel Charitable Foundation, National Health and Medical Research Council of Australia (NHMRC), Queensland Government, Townsville Hospital Private Practice Trust, University of Oxford (UO), Medical Research Council (MRC), British Heart Foundation (BHF), Cancer Research UK, National Heart Foundation of Australia, Western Australian Health Promotion Foundation, Freemantle Hospital Medical Research Foundation
Projects and Grants: NHMRC 1079369, NHMRC 1079193, NHMRC 1063476, NHMRC 1022752, NHMRC 1003707, NHMRC 1021416, NHMRC 1000967, NHMRC 109921, UO MRC Population Health Research Unit, NHMRC 964145, NHMRC 139093, NHMRC 403963, NHMRC 455811, NHMRC 1021416, NHMRC 1000967, NHMRC 1045710, NHMRC 1060557
Date Deposited: 31 Jan 2018 07:31
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified @ 100%
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