Association of obesity with risk of coronary heart disease: findings from the National Health and Nutrition Examination Survey, 1999–2006
Received 9 October 2009; received in revised form 5 January 2010; accepted 5 February 2010. published online 22 February 2010. Uncorrected Proof
Abstract
Background
Obesity is a well-known risk factor for the development of coronary heart disease (CHD). The aim of the present study was to examine the differences in the 10-year CHD risk with increasing severity of obesity in men and women participating in the latest National Health and Nutrition Examination Survey.
Methods
Data from a representative sample of 12,500 U.S. participants in the National Health and Nutrition Examination Survey from 1999 to 2006 were reviewed. The Framingham risk score was calculated for men and women according to a body mass index (BMI) of <25.0, 25.0–29.9, 30.0–34.9, and ≥35.0 kg/m2.
Results
The prevalence of those with hypertension increased with an increasing BMI, from 24% for a BMI <25.0 kg/m2 to 54% for a BMI of ≥35.0 kg/m2. The prevalence of an abnormal total cholesterol level (>200 mg/dL) increased from 40% for a BMI <25.0 kg/m2 to 48% for a BMI of ≥35.0 kg/m2. The 10-year CHD risk for men increased from 3.1% for a BMI <25.0 kg/m2 to a peak of 5.6% for a BMI of 30.0–34.9 kg/m2. The 10-year CHD risk for women increased from .8% for a BMI <25.0 kg/m2 to a peak of 1.5% for a BMI of ≥35.0 kg/m2. Both diabetes and hypertension were independent risk factors for an increasing CHD risk.
Conclusions
The 10-year CHD risk, calculated using the Framingham risk score, substantially increased with an increasing BMI. An important implication from our findings is the need to implement surgical and medical approaches to weight reduction to reduce the effect of morbidity and mortality from CHD on the U.S. healthcare system.
aDepartment of Surgery, University of California, Irvine, Medical Center, Orange, California
bCenter for Health Policy Research, University of California, Irvine, Medical Center, Orange, California
Reprint requests: Ninh T. Nguyen, M.D., Department of Surgery, University of California, Irvine, Medical Center, 333 City Building West, Suite 850, Orange, CA 92868
Presented as a poster at the American Society for Metabolic and Bariatric Surgery on June 24, 2009, Grapevine, Texas.
ABSTRACT