Key result
The risk of fatal coronary heart disease associated with body mass index increased with the duration of follow-up over 21 years (test of trend: p=0.002).
Why the study?
Does the predictiveness of body mass index and other coronary risk factors for fatal coronary heart disease vary according to the length of follow-up in men?
Cohort (n=14,403)
Does the predictiveness of body mass index and other coronary risk factors for fatal coronary heart disease vary according to the length of follow-up in men?
p-value: p=0.002
The predictive strength of BMI for fatal CHD increases over time, indicating that the cardiovascular harm associated with obesity may take more than a decade to fully manifest compared to classical risk factors.
Shorter follow-up may underestimate BMI-related fatal CHD risk; leaves open whether time-dependent effects warrant refined models in cohorts.
AIMS: To test the association between body mass index (BMI) and other coronary risk factors and the risk of a fatal coronary heart disease (CHD) event in different time periods during follow-up. METHODS: Prospective cohort study with a 21 year follow-up period. A screened sample of 14,403 men aged 40-49 years initially free of CHD. Risk of fatal CHD was calculated for 21 years' cumulative follow-up and for four consecutive 5-year periods. RESULTS: After adjustment for age and the other risk factors, total cholesterol and systolic blood pressure retained their predictive strength for CHD mortality throughout follow-up. Though cigarette smoking remained a significant predictor, the relative risk decreased with time (test of trend: p=0.01). Intermediate to vigorous physical activity at leisure was protective for 10 years of follow-up and a question on mental stress for 5 years. The test of trend indicated that the risk associated with BMI increased with the duration of follow-up (p=0.002). CONCLUSIONS: Our data show that coronary risk factors predicted CHD mortality differently according to the length of follow-up, and suggest that the harm associated with obesity may take more than a decade to become evident, in contrast to the classical CHD risk factors.
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Håheim et al. (2005) conducted a cohort in Coronary heart disease (n=14,403). Body mass index (BMI) was evaluated on Fatal coronary heart disease (CHD) event (p=0.002). The risk of fatal coronary heart disease associated with body mass index increased with the duration of follow-up over 21 years (test of trend: p=0.002).
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