Obesity and Atherosclerotic Heart Disease Incidence Highest in Black Women

MedicalResearch.com Interview with:
Duke Appiah, PhD, MPH
Postdoctoral Fellow
Division of Epidemiology and Community Health
University of Minnesota
Minneapolis, MN 55454

MedicalResearch.com: What is the background for this study?

Dr. Appiah: Atherosclerotic cardiovascular disease (ASCVD) mortality has decreased in recent decades with the rate of decline greater in whites than blacks. Obesity and ASCVD events are disproportionately higher among middle-aged blacks than whites with the adverse health effects of obesity especially elevated for black women. Given the current obesity epidemic and the known negative associations of obesity on ASCVD risk, we assessed whether longitudinal changes in body mass index (BMI) were positively associated with changes in 10-year AHA/ACC ASCVD risk scores in middle-aged blacks compared to whites.

MedicalResearch.com: What are the main findings?

Dr. Appiah:  We found that in our cohort, the prevalence of obesity increased from 32.3% in 2000-2001 (mean age: 42.8 years) to 41.7% in 2010-2011, higher in blacks than whites. Additionally, blacks were observed to have higher 10-year change ASCVD risk (men: 4.5 to 9.6%, women: 1.7 to 5.0%) than whites (men: 2.4 to 5.2%, women: 0.7 to 1.6%). Furthermore, black women had the highest prevalence of obesity (64.2%) with a greater proportion of them also having 10-year risk ASCVD risk ≥ 7.5% compared to white men and women. Although BMI was associated with ASCVD risk factor levels, longitudinal trends of BMI had little independent effect on the estimation of 10-year ASCVD risk scores, most likely due to its influence being mediated through risk factors already included in the risk score.

MedicalResearch.com: What should readers take away from your report?

Dr. Appiah:

First, our findings do not in any way downplay the importance of obesity as a modifiable risk factor for ASCVD as obesity is related to diabetes, hypertension, and dyslipidemia.

Second, they provide valuable information of changes in BMI trends and ASCVD risk score trends for black and white men and women as they transition from young adulthood to middle age. Such information is currently lacking in the literature.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Appiah:  With obesity in middle age associated with greater prevalence of CVD risk factors relative to normal weight individuals, and the duration and severity of obesity playing major roles on the incidence of CVD events, primary prevention of ASCVD risk factors associated with excess weight gain may be needed to improve cardiovascular health among middle-aged adults, especially blacks.

The question I would ask is why some obese individuals develop adverse CVD risk factors and some do not. Primordial prevention of obesity, nonetheless, is critical for primary prevention of ASCVD risk factors on the causal pathway to frank CVD events.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


Relation of longitudinal changes in body mass index with atherosclerotic cardiovascular disease risk scores in middle-aged black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Appiah, Duke et al.
Annals of Epidemiology , Volume 0 , Issue 0 , June 17, 2016

DOI: http://dx.doi.org/10.1016/j.annepidem.2016.06.008

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Last Updated on June 22, 2016 by Marie Benz MD FAAD