Overweight and obesity as determinants of cardiovascular risk - The Framingham experience
Overweight and obesity as determinants of cardiovascular risk - The Framingham experience
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DOI：
10.1001/archinte.162.16.1867
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发表时间：
2002-09-09
影响因子：
--
通讯作者：
Kannel, WB
中科院分区：
文献类型：
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作者：
Wilson, PWF;D'Agostino, RB;Kannel, WB
背景：据我们所知，还没有关于超重状态对高血压、高胆固醇血症、糖尿病和心血管后遗症风险的长期影响的单一研究报道。方法：前瞻性地研究了35岁至75岁的弗雷明翰心脏研究参与者的体重指数(BMI)类别、心血管疾病危险因素和血管疾病终点之间的关系，并对他们进行了长达44年的随访。主要结果是新的心血管疾病。疾病，包括心绞痛、心肌梗死、冠心病或中风。分析比较超重(BMI[体重除以身高(米)的平方]，25.0-29.9)和肥胖者(BMI大于或等于30)与正常体重的参照组(BMI，18.5-24.9)。结果：年龄调整后的新高血压的相对风险(RR)与超重状态高度相关(男性：RR，1.46；女性：RR，1.75)。新发的高胆固醇血症和糖尿病与过度肥胖的相关性较低。超重者(男性：1.21[1.05-1.40]；女性：1.20[1.03-1.41])和肥胖者(男性：1.46[1.20-1.77]；女性：1.64[1.37-1.98])患心血管疾病的年龄调整RR(可信区间[CI])增加。高血压(26%男性；28%女性)、心绞痛(26%男性；22%女性)和冠心病(23%男性；15%女性)的高人群归因风险与超重(BMI大于或等于25)有关。结论：超重类别与高血压和心血管后遗症的相对和人群归因风险增加有关。减少肥胖和避免超重的干预措施可能会在个人和人群层面上对危险因素和心血管疾病的发展产生重大影响。
Background: To our knowledge, no single investigation concerning the long-term effects of overweight status on the risk for hypertension, hypercholesterolemia, diabetes mellitus, and cardiovascular sequelae has been reported.Methods: Relations between categories of body mass index (BMI), cardiovascular disease risk factors, and vascular disease end points were examined prospectively in Framingham Heart Study participants aged 35 to 75 years, who were followed up to 44 years. The primary outcome was new cardiovascular. disease, which included angina pectoris, myocardial infarction, coronary heart disease, or stroke. Analyses compared overweight (BMI [calculated as weight in kilograms divided by the square of height in meters], 25.0-29.9) and obese persons (BMI greater than or equal to30) to a referent group of normal-weight persons (BMI, 18.5-24.9).Results: The age-adjusted relative risk (RR) for new hypertension was highly associated with overweight status (men: RR, 1.46; women: RR, 1.75). New hypercholesterolemia and,diabetes mellitus were less highly associated with excess adiposity. The age-adjusted RR (confidence interval [CI]) for cardiovascular disease was increased among those who were overweight (men: 1.21 [1.05-1.40]; women: 1.20 [1.03-1.41]) and the obese (men: 1.46 [1.20-1.77]; women: 1.64 [1.37-1.98]). High population attributable risks were related to excess weight (BMI greater than or equal to25) for the outcomes hypertension (26% men; 28% women), angina pectoris (26% men; 22% women), and coronary heart disease (23% men; 15% women).Conclusions: The overweight category is associated with increased relative and population attributable risk for hypertension and cardiovascular sequelae. Interventions to reduce adiposity and avoid excess weight may have large effects on the development of risk factors and cardiovascular disease at an individual and population level.