Stable Severe Obesity Tied to Increased Risk of HF, CVD and Mortality

Takeaway

• The majority of adults in a UK cohort study who were overweight or obese retained their degree of overweight or obesity in the long term.
• Individuals with stable severe obesity had an increased risk of heart failure (HF), cardiovascular disease (CVD) and mortality.

Why this matters

• Findings highlight the negative impact on cardiovascular health as a result of failure to tackle the obesity crisis.
• Further research is warranted to determine the effects of interventions to change body mass index (BMI) trajectories on future CVD outcomes.

Study design

• A population-based cohort study of 264,230 overweight and obese individuals from the UK Clinical Practice Research Datalink (CPRD).
• All patients were categorised into 4 BMI trajectory groups according to the World Health Organisation BMI classifications:
  • group 1 (overweight [BMI, 28.7 kg/m²]; n=95,944);
  • group 2 (class 1 obesity [BMI, 33.7 kg/m²]; n=104,616);
  • group 3 (class 2 obesity [BMI, 39.9 kg/m²]; n=50,866); and
  • group 4 (class 3 obesity [BMI, 49.1 kg/m²]; n=12,804).
• Funding: None.

Key results

• A small stable upward trajectory in BMI was observed across all 4 groups, corresponding to an overall mean BMI increase of 1.06 kg/m² (±3.8) over 10 years.
• Class 3 obese vs overweight individuals had an increased risk of:
  • overall CVD (adjusted HR [aHR], 1.40; 95% CI, 1.33-1.48);
  • HF (aHR, 3.26; 95% CI, 2.98-3.57);
  • all-cause mortality (aHR, 2.72; 95% CI, 2.58-2.87); and
  • CVD-related mortality (aHR, 3.31; 95% CI, 2.84-3.86).
• Risk of peripheral vascular disease was lower in class 3 obese vs overweight individuals (aHR, 0.73; 95% CI, 0.60-0.89).

Limitations

• BMI is a surrogate measure of adiposity.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.