Cohort study of effect of being overweight and change in weight on risk of coronary heart disease in old age
Key result
A body mass index of 27 or more in late middle age increased the risk of coronary heart disease in late life by 70% (RR 1.7) compared to those in the lowest third of body mass index.
Why the study?
Does being overweight or experiencing weight change increase the risk of incident coronary heart disease in older adults?
Population
1,581 adults free of coronary heart disease in 1982-84, mean age 77 years, from the United States.
Comparison
Being overweight in late middle age or old age… vs Thinner people with stable weight.
Design
Cohort
Authors
Discussion
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Implication
Midlife overweight was associated with higher late-life CHD risk; leaves open whether weight history refines risk models in older adults.
Study Design
Type
Cohort (n=1,581)
Structured PICO
Does being overweight or experiencing weight change increase the risk of incident coronary heart disease in older adults?
P
Population
1,581 adults (621 men and 960 women) free of coronary heart disease in 1982-84, mean age 77 years, from the United States (NHANES I epidemiological follow-up study).
I
Intervention
Being overweight (body mass index ≥27) in late middle age or old age, and weight change (loss or gain of ≥10% body weight).
C
Comparator
Thinner people with stable weight (body mass index <27).
O
Outcome
Incidence of coronary heart disease.hard clinical
Main Result
Effect estimate: RR 1.7 (95% CI 1.3-2.1)
Being overweight in late middle age and significant weight changes are important risk factors for coronary heart disease in older adults, highlighting the importance of weight history in risk assessment.
Limitations
- Case ascertainment based primarily on hospital discharge diagnoses and death certificates
- Potential misclassification of current body mass index since current height is likely to be shorter than past height
- Lack of direct information on reasons for weight loss
- Silent myocardial infarctions could result in missed cases
Cite This Study
Harris et al. (1997) conducted a cohort in Free of coronary heart disease (n=1,581). Body mass index of 27 or more in late middle age vs. Lowest third of body mass index was evaluated on Incidence of coronary heart disease (RR 1.7, 95% CI 1.3-2.1). A body mass index of 27 or more in late middle age increased the risk of coronary heart disease in late life by 70% (RR 1.7) compared to those in the lowest third of body mass index.