Among individuals with obesity, weight loss was associated with a lower risk of coronary heart disease (RD -1.4%; 95% CI -2.4% to -0.6%), while weight gain increased CVD risk across all BMI groups.
Observational (n=138,567)
Does weight change (loss or gain) alter the 7-year risk of cardiovascular disease in adults aged 45-69 without chronic disease compared to weight maintenance?
Weight loss in obese individuals is associated with a lower risk of coronary heart disease, whereas weight gain increases cardiovascular risk across all BMI categories.
Effect estimate: RD -1.4% (95% CI -2.4% to -0.6%)
BACKGROUND: Cross-sectional measures of body mass index (BMI) are associated with cardiovascular disease (CVD) incidence, but less is known about whether weight change affects the risk of CVD. METHODS: We estimated the effect of 2-y weight change interventions on 7-y risk of CVD (CVD death, myocardial infarction, stroke, hospitalization from coronary heart disease, and heart failure) by emulating hypothetical interventions using electronic health records. We identified 138,567 individuals with 45-69 years of age without chronic disease in England from 1998 to 2016. We performed pooled logistic regression, using inverse-probability weighting to adjust for baseline and time-varying confounders. We categorized each individual into a weight loss, maintenance, or gain group. RESULTS: Among those of normal weight, both weight loss risk difference (RD) vs. weight maintenance = 1.5% (0.3% to 3.0%) and gain RD = 1.3% (0.5% to 2.2%) were associated with increased risk for CVD compared with weight maintenance. Among overweight individuals, we observed moderately higher risk of CVD in both the weight loss RD = 0.7% (-0.2% to 1.7%) and the weight gain group RD = 0.7% (-0.1% to 1.7%), compared with maintenance. In the obese, those losing weight showed lower risk of coronary heart disease RD = -1.4% (-2.4% to -0.6%) but not of stroke. When we assumed that chronic disease occurred 1-3 years before the recorded date, estimates for weight loss and gain were attenuated among overweight individuals; estimates for loss were lower among obese individuals. CONCLUSION: Among individuals with obesity, the weight-loss group had a lower risk of coronary heart disease but not of stroke. Weight gain was associated with increased risk of CVD across BMI groups. See video abstract at, http://links.lww.com/EDE/B838.
Katsoulis et al. (Wed,) conducted a observational in Cardiovascular disease (n=138,567). Weight loss or weight gain vs. Weight maintenance was evaluated on 7-y risk of CVD (CVD death, myocardial infarction, stroke, hospitalization from coronary heart disease, and heart failure) (RD -1.4%, 95% CI -2.4% to -0.6%). Among individuals with obesity, weight loss was associated with a lower risk of coronary heart disease (RD -1.4%; 95% CI -2.4% to -0.6%), while weight gain increased CVD risk across all BMI groups.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: