The ‘obesity paradox’ in cardiovascular diseases: age matters!
Why the study?
It was unclear whether the typical U-shaped association between BMI and mortality remains constant across all age groups.
Does the association between BMI and cardiovascular outcomes or mortality vary by age in individuals without prior cardiovascular disease?
Population
More than 9 million Koreans without prior CVD
Comparison
Six BMI categories across young, middle-aged, and elderly age bands
Design
Editorial
Authors
Discussion
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Member takes
Implication
May inform age-specific BMI counseling but should not yet change practice; extends the obesity paradox and leaves open age-stratified weight-loss trials.
Structured PICO
Does the association between BMI and cardiovascular outcomes or mortality vary by age in individuals without prior cardiovascular disease?
P
Population
Over 9 million Koreans without prior cardiovascular disease, subdivided into six BMI categories and stratified into three age bands: young (20–39 years), middle-aged (40–64 years), and elderly (≥65 years).
I
Intervention
Body mass index (BMI) categories (severely underweight, mildly underweight, optimal normal weight, high normal weight, pre-obese, and obese)
C
Comparator
Comparisons across different BMI categories and age groups
O
Outcome
Occurrence of myocardial infarction (MI), heart failure (HF), and all-cause deathhard clinical
The obesity paradox in cardiovascular disease is highly age-dependent, suggesting that weight loss recommendations should be tailored to the patient's age.
Limitations
- Ethnicity variations make it difficult to generalize findings to European, North American, and African populations
- BMI is not able to discriminate between fat mass, lean mass, and adiposity subtypes
- The limit of 65 years to define elderly might be discussable in a country with life expectancy >82 years
Cite This Study
Boukhris et al. (2022) studied this question.