Risk factors for first acute myocardial infarction attack assessed by cardiovascular disease registry data in Aichi Prefecture.

Recently, in Western countries, metabolic syndrome as well as such classical risk factors as hypertension and smoking has been considered to be closely associated with the occurrence of acute myocardial infarction (AMI). Therefore, we conducted a case-control study to investigate how the co-morbidity of obesity or thinness with hypertension, hyperlipidemia and diabetes mellitus would affect AMI occurrence among Japanese aged 30 to 69. Cases were comprised of 788 patients (590 men and 198 women) registered in the "Aichi Prefecture Cardiovascular Disease Registry Program" during hospitalization due to their first AMI attack. Controls were 2,300 randomly sampled inhabitants (1,142 men and 1,158 women) who responded to the questionnaire survey on lifestyle. We decided BMI < 18.5 as thin, 18.5 < or = BMI < 25.0 as normal, and BMI > or = 25.0 as obese, then divided subjects into six groups according to the presence or absence of histories of the above-mentioned three diseases in connection with their physique. In both sexes, multivariately adjusted odds ratios of first AMI attacks were much higher in groups with such histories (men, 4.14 to approximately 5.07; women, 5.62 to approximately 15.24) than in those without them (men, 0.90 to approximately 1.13; women, 1.54 to approximately 3.03) regardless of physique. Only in women, obesity uncombined with histories was significantly associated with AMI occurrence and not obesity but thinness intensified the association between histories and AMI. Among the six groups, population attributable risk percent was highest in the normal physique group with histories. It was suggested that persons with disease histories should be carefully treated irrespective of the presence or absence of obesity.