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Obesity (Silver Spring). 2014 Mar;22(3):801-10. doi: 10.1002/oby.20224. Epub 2014 Feb 3.

Severe obesity, heart disease, and death among white, African American, and Hispanic postmenopausal women.

Author information

1
University of Pittsburgh Departments of Medicine & Public Health, Pittsburgh, Pennsylvania, USA.

Abstract

OBJECTIVE:

To compare mortality, nonfatal coronary heart disease (CHD), and congestive heart failure (CHF) risk across BMI categories in white, African American, and Hispanic women, with a focus on severe obesity (BMI ≥ 40), and examine heterogeneity in weight-related CHD risk.

METHODS:

Among 156,775 Women's Health Initiative observational study and clinical trial participants (September 1993-12 September 2005), multivariable Cox models estimated relative risk for mortality, CHD, and CHF. CHD incidence was calculated by anthropometry, race, and cardiovascular risk factors (CVRF).

RESULTS:

Mortality, nonfatal CHD, and CHF incidence generally rose with BMI category. For severe obesity versus normal BMI, hazard ratios (HRs, 95% confidence interval) for mortality were 1.97 (1.77-2.20) in white, 1.55 (1.20-2.00) in African American, and 2.59 (1.55-4.31) in Hispanic women; for CHD, HRs were 2.05 (1.80-2.35), 2.24 (1.57-3.19), and 2.95 (1.60-5.41) respectively; for CHF, HRs were 5.01 (4.33-5.80), 3.60 (2.30-5.62), and 6.05 (2.49-14.69). CVRF variation resulted in substantial variation in CHD rates across BMI categories, even in severe obesity. CHD incidence was similar by race/ethnicity when differences in BMI or CVRF were accounted for.

CONCLUSIONS:

Severe obesity increases mortality, nonfatal CHD, and CHF risk in women of diverse race/ethnicity. CVRF heterogeneity contributes to variation in CHD incidence even in severe obesity.

KEYWORDS:

cardiovascular diseases/epidemiology; cardiovascular diseases/etiology; longitudinal studies; obesity, morbid/complications; obesity, morbid/epidemiology; obesity/epidemiology, obesity/complications

PMID:
24493096
DOI:
10.1002/oby.20224
[Indexed for MEDLINE]
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