What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary heart disease (n=1178939). Intervention: Body mass index vs. Lower body mass index. Primary outcome: Incident coronary heart disease (first hospitalization or death) (RR 1.23, 95% CI 1.22-1.25).

April 2, 2013BMC MedicineOpen Access

Body mass index and incident coronary heart disease in women: a population-based prospective study

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Key result

Incident coronary heart disease in women increases progressively with body mass index, with an adjusted relative risk of 1.23 per 5 kg/m2 increase in BMI.

Why the study?

Does a higher body mass index increase the risk of incident coronary heart disease in women?

Population

1,178,939 women without heart disease, stroke, or cancer at baseline, recruited from the Million Women Study…

Comparison

Higher body mass index, assessed as a continuous… vs Lower body mass index categories.

Design

Cohort

Follow-up

average of 9 years

Authors

DCDexter CanoyPreventive Cardiology BCBenjamin J. CairnsQueen's University Belfast ABAngela BalkwillUniversity of Oxford

Discussion

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Implication

Supports weight management for primary CHD prevention in women; extends observational data but leaves causal effects open.

Study Design

Type

Cohort (n=1,178,939)

Multicenter

Yes

Structured PICO

Does a higher body mass index increase the risk of incident coronary heart disease in women?

Population

1,178,939 middle-aged women without prior heart disease, stroke, or cancer, followed for an average of 9 years to assess incident coronary heart disease.

Exposure

Higher body mass index (BMI), assessed as a continuous variable (per 5 kg/m2 increase) and in categories (e.g., 25 to 29.9, 30 to 34.9, ≥35 kg/m2).

Comparator

Lower body mass index categories (e.g., BMI 20 to 24.9 kg/m2 or 22.5 to 24.9 kg/m2).

Outcome

Incident CHD event (defined as the first hospital admission after recruitment with a diagnosis of CHD or death with CHD as the underlying cause).hard clinical

Main Result

Relative Risk: 1.23 (95% CI 1.22–1.25)

In a large cohort of women, incident CHD risk increased progressively with BMI, whereas CHD mortality exhibited a J-shaped relationship, highlighting the importance of weight management for primary prevention.

Limitations

Use of self-reported weight and height at baseline to calculate BMI, which can change over time
Assessed only BMI as an indicator of total adiposity, without measuring abdominal adiposity
Included women only, though relative risks may not differ from men, absolute risks may not be directly applicable to other populations
Coronary heart disease may be clinically under-diagnosed in women
Used self-reported weight and height at baseline, which can change over time
Assessed only BMI, an indicator of total adiposity, but not abdominal adiposity
Included women only
Absolute risks may not be directly applicable to women in different populations
CHD may be clinically underdiagnosed in women

Cite This Study

Canoy et al. (2013) conducted a cohort in Coronary heart disease (n=1,178,939). Body mass index vs. Lower body mass index was evaluated on Incident coronary heart disease (first hospitalization or death) (RR 1.23, 95% CI 1.22-1.25). Incident coronary heart disease in women increases progressively with body mass index, with an adjusted relative risk of 1.23 per 5 kg/m2 increase in BMI.

synapsesocial.com/papers/6a92be72e5596d780b1f8038 https://doi.org/10.1186/1741-7015-11-87

Topics

Women and heart disease

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Body mass index and incident coronary heart disease in women: a population-based prospective study

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Body mass index and incident coronary heart disease in women: a population-based prospective study

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider