obesity is not a direct risk factor for cardiovascular disease

From: Doug Skrecky (oberon@vcn.bc.ca)
Date: Wed Oct 06 1999 - 22:04:32 MDT


Authors
  Schulte H. Cullen P. Assmann G.
Institution
  Institut fur Arterioskleroseforschung, an der Universitat Munster, Germany.
Title
  Obesity, mortality and
  cardiovascular disease in the Munster Heart Study (PROCAM).
Source
  Atherosclerosis. 144(1):199-209, 1999 May.
Abstract
  In the Munster Heart Study (PROCAM), 16,288 men aged 40.6 +/- 11.3 years
  (mean +/- S.D.) and 7328 women aged 36.0 +/- 12.3 years were enrolled between
  1979 and 1991. Mean body mass indices (BMIs) were 25.6 +/- 3.3 and 23.8 +/-
  4.1 kg/m2 in men and women, respectively. There was a graded and continuous
  positive interaction in both men and women between BMI, age and serum total
  cholesterol, low density lipoprotein (LDL) cholesterol, and blood pressure
  (both systolic and diastolic). High density lipoprotein (HDL) cholesterol
  tended to increase with age, but decreased in graded fashion with increases
  in BMI in both sexes. Triglyceride increased with BMI in both sexes and with
  age in women, but decreased in the older age groups of overweight and obese
  men. Though fasting blood glucose increased with age and BMI in both sexes,
  the increase was more marked in women. Among the 10,856 men aged 36-65 years
  at study entry, 313 deaths occurred within a follow-up period of 7.1 +/- 2.4
  years. Among these men, increased mortality was seen at high
  BMIs in both smokers and non-smokers and was caused by coronary heart disease
  (CHD). Increased mortality at low BMI was seen in smokers
  but not in non-smokers and was due to an increase in cancer deaths. The
  BMI-associated increase in CHD death was completely accounted for by the
  factors contained in the Munster Heart Study (PROCAM) risk algorithm,
  indicating that the effect of overweight and obesity on CHD is mediated via
  other risk factors.



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