Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 7-Day Trial for You or Your Team.

Learn More →

Obesity related risk of sudden cardiac death in the atherosclerosis risk in communities study

Obesity related risk of sudden cardiac death in the atherosclerosis risk in communities study Objective To examine the association of body mass index (BMI), waist circumference (WC) and waist hip ratio (WHR) with sudden cardiac death (SCD) in community dwelling individuals. Methods Data from a multicentre, prospective, cohort study of 14 941 men and women (African American, and white), aged 45–64 years, participating in the Atherosclerosis Risk in Communities study was analysed. Obesity measures were assessed at baseline (1987–1989). SCD was adjudicated by a committee. Results At enrolment mean±SD age of the participants was 54±6 years (55% female; 26% African American). During 12.6±2.5 years of follow-up, 253 SCD occurred (incidence rate 1.34/100 person-years). The association between obesity and SCD differed by smoking status (interaction p≤0.01). In models adjusting for age, sex, race, study centre and education level, SCD risk was positively associated (p<0.001) with BMI, WC and WHR in non-smokers, but not in smokers. WHR was more strongly associated with SCD in non-smokers than was BMI or WC (HR per SD increment (95% CI) 2.00 (1.65 to 2.42); 1.34 (1.15 to 1.56) and 1.49 (1.28 to 1.74), respectively). After adjustment for potential mediators (hypertension, diabetes, lipid profile, prevalent coronary heart disease, heart failure, and LV hypertrophy), non-smokers in the highest WHR category (>0.95 in women; >1.01 in men) had double the risk of SCD (HR 2.03, 95% CI 1.19 to 3.46; incidence rate 1.43/1000 person-years) versus those with normal WHR. Conclusions General obesity is associated with increased risk of SCD in middle-aged, non-smoking individuals, mediated by traditional cardiovascular risk factors. Central obesity, however, is independently associated with SCD by pathways that remain to be elucidated. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Heart British Medical Journal

Obesity related risk of sudden cardiac death in the atherosclerosis risk in communities study

Download PDF

Obesity related risk of sudden cardiac death in the atherosclerosis risk in communities study

Adabag, Selcuk; Huxley, Rachel R; Lopez, Faye L; Chen, Lin Y; Sotoodehnia, Nona; Siscovick, David; Deo, Rajat; Konety, Suma; Alonso, Alvaro; Folsom, Aaron R
Heart , Volume 101 (3) – Feb 1, 2015

Abstract


Objective
To examine the association of body mass index (BMI), waist circumference (WC) and waist hip ratio (WHR) with sudden cardiac death (SCD) in community dwelling individuals.

Methods
Data from a multicentre, prospective, cohort study of 14 941 men and women (African American, and white), aged 45–64 years, participating in the Atherosclerosis Risk in Communities study was analysed. Obesity measures were assessed at baseline (1987–1989). SCD was adjudicated by a committee.

Results
At enrolment mean±SD age of the participants was 54±6 years (55% female; 26% African American). During 12.6±2.5 years of follow-up, 253 SCD occurred (incidence rate 1.34/100 person-years). The association between obesity and SCD differed by smoking status (interaction p≤0.01). In models adjusting for age, sex, race, study centre and education level, SCD risk was positively associated (p<0.001) with BMI, WC and WHR in non-smokers, but not in smokers. WHR was more strongly associated with SCD in non-smokers than was BMI or WC (HR per SD increment (95% CI) 2.00 (1.65 to 2.42); 1.34 (1.15 to 1.56) and 1.49 (1.28 to 1.74), respectively). After adjustment for potential mediators (hypertension, diabetes, lipid profile, prevalent coronary heart disease, heart failure, and LV hypertrophy), non-smokers in the highest WHR category (>0.95 in women; >1.01 in men) had double the risk of SCD (HR 2.03, 95% CI 1.19 to 3.46; incidence rate 1.43/1000 person-years) versus those with normal WHR.

Conclusions
General obesity is associated with increased risk of SCD in middle-aged, non-smoking individuals, mediated by traditional cardiovascular risk factors. Central obesity, however, is independently associated with SCD by pathways that remain to be elucidated.

Loading next page...
 
/lp/british-medical-journal/obesity-related-risk-of-sudden-cardiac-death-in-the-atherosclerosis-llZyLp1jHR

References

References for this paper are not available at this time. We will be adding them shortly, thank you for your patience.

Publisher
British Medical Journal
Copyright
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
ISSN
1355-6037
eISSN
1468-201X
DOI
10.1136/heartjnl-2014-306238
Publisher site
See Article on Publisher Site

Abstract

Objective To examine the association of body mass index (BMI), waist circumference (WC) and waist hip ratio (WHR) with sudden cardiac death (SCD) in community dwelling individuals. Methods Data from a multicentre, prospective, cohort study of 14 941 men and women (African American, and white), aged 45–64 years, participating in the Atherosclerosis Risk in Communities study was analysed. Obesity measures were assessed at baseline (1987–1989). SCD was adjudicated by a committee. Results At enrolment mean±SD age of the participants was 54±6 years (55% female; 26% African American). During 12.6±2.5 years of follow-up, 253 SCD occurred (incidence rate 1.34/100 person-years). The association between obesity and SCD differed by smoking status (interaction p≤0.01). In models adjusting for age, sex, race, study centre and education level, SCD risk was positively associated (p<0.001) with BMI, WC and WHR in non-smokers, but not in smokers. WHR was more strongly associated with SCD in non-smokers than was BMI or WC (HR per SD increment (95% CI) 2.00 (1.65 to 2.42); 1.34 (1.15 to 1.56) and 1.49 (1.28 to 1.74), respectively). After adjustment for potential mediators (hypertension, diabetes, lipid profile, prevalent coronary heart disease, heart failure, and LV hypertrophy), non-smokers in the highest WHR category (>0.95 in women; >1.01 in men) had double the risk of SCD (HR 2.03, 95% CI 1.19 to 3.46; incidence rate 1.43/1000 person-years) versus those with normal WHR. Conclusions General obesity is associated with increased risk of SCD in middle-aged, non-smoking individuals, mediated by traditional cardiovascular risk factors. Central obesity, however, is independently associated with SCD by pathways that remain to be elucidated.

Journal

Heart – British Medical Journal

Published: Feb 1, 2015

References

  • Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism
    Poirier, P; Giles, TD; Bray, GA
  • National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants
    Finucane, MM; Stevens, GA; Cowan, MJ
  • Annual medical spending attributable to obesity: payer-and service-specific estimates
    Finkelstein, EA; Trogdon, JC; Cohen, JW
  • Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies
    Whitlock, G; Lewington, S; Sherliker, P
  • Association between adiposity in midlife and older age and risk of diabetes in older adults
    Biggs, ML; Mukamal, KJ; Luchsinger, JA
  • Measures of adiposity and future risk of ischemic stroke and coronary heart disease in older men and women
    Kizer, JR; Biggs, ML; Ix, JH
  • Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk—a review of the literature
    Huxley, R; Mendis, S; Zheleznyakov, E
  • Is there a cardiomyopathy of obesity?
    Owan, T; Litwin, SE
  • Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure
    Lavie, CJ; Alpert, MA; Arena, R
  • Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome
    Alpert, MA
  • Obesity and the electrocardiogram
    Fraley, MA; Birchem, JA; Senkottaiyan, N
  • Etiology of sudden death in the community: results of anatomical, metabolic, and genetic evaluation
    Adabag, AS; Peterson, G; Apple, FS
  • Causes of nonischemic sudden cardiac death in the current era
    Hookana, E; Junttila, MJ; Puurunen, VP
  • Distinctive profile of sudden cardiac arrest in middle-aged vs. older adults: a community-based study
    Noheria, A; Teodorescu, C; Uy-Evanado, A
  • Precursors of sudden coronary death. Factors related to the incidence of sudden death
    Kannel, WB; Doyle, JT; McNamara, PM
  • Prospective study of sudden cardiac death among women in the United States
    Albert, CM; Chae, CU; Grodstein, F
  • Risk factors for sudden cardiac death in post-menopausal women
    Bertoia, ML; Allison, MA; Manson, JE
  • Sagittal abdominal diameter and risk of sudden death in asymptomatic middle-aged men: the Paris Prospective Study I
    Empana, JP; Ducimetiere, P; Charles, MA
  • Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case–control study
    Yusuf, S; Hawken, S; Ounpuu, S
  • Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies
    Wormser, D; Kaptoge, S; Di Angelantonio, E
  • Hemostasis, inflammation, and fatal and nonfatal coronary heart disease: long-term follow-up of the atherosclerosis risk in communities (ARIC) cohort
    Kucharska-Newton, AM; Couper, DJ; Pankow, JS
  • Inflammation and sudden cardiac death in a community-based population of older adults: the Cardiovascular Health Study
    Hussein, AA; Gottdiener, JS; Bartz, TM
  • Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss
    Lavie, CJ; Milani, RV; Ventura, HO
  • Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death
    Haider, AW; Larson, MG; Benjamin, EJ
  • Regression of electrocardiographic left ventricular hypertrophy during antihypertensive therapy and reduction in sudden cardiac death: the LIFE Study
    Wachtell, K; Okin, PM; Olsen, MH
  • Sudden death after myocardial infarction
    Adabag, AS; Therneau, TM; Gersh, BJ
  • Overweight and sudden death. Increased ventricular ectopy in cardiopathy of obesity
    Messerli, FH; Nunez, BD; Ventura, HO
  • Determinants of prolonged QT interval and their contribution to sudden death risk in coronary artery disease: the Oregon Sudden Unexpected Death Study
    Chugh, SS; Reinier, K; Singh, T