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Being obese for longer worsens cardio risk factors

Atherosclerosis more likely, and worse in those obese for over 20 years

Louise Prime

Wednesday, 17 July 2013

People who have been obese for longer are at higher risk of subclinical atherosclerosis, research has shown. Authors of the study, published today in JAMA, warn that rates of clinical cardiovascular disease could rise as obesity in adolescents becomes more common.

US researchers investigated the associations between duration of overall and abdominal obesity, and coronary artery calcification (CAC). They studied 3275 white and black men and women who, at baseline in 1985-86, were aged 18-30 years and had neither overall obesity (body mass index ≥30) nor abdominal obesity (waist circumference ≥102cm for men, ≥88cm for women).

Participants’ BMI and waist measurements were again recorded at 2-, 5-, 7-, 10-, 15-, 20- and 25-year follow-up examinations. In addition, at the 15-, 20-, and 25-year follow-ups, they had computed tomography scanning to detect CAC. During follow-up, about two in five participants developed overall obesity (40.4%) and abdominal obesity (41.0%); average duration of obesity was 13.3 and 12.2 years, respectively. More than a quarter (27.5%) of them, overall, developed CAC.

The researchers found that both the presence and the extent of CAC were associated with the duration of overall and of abdominal obesity. They said: “Approximately 38.2% and 39.3% of participants with more than 20 years of overall and abdominal obesity, respectively, had CAC compared with 24.9% and 24.7% of those who never developed overall or abdominal obesity.

“Extensive CAC was present in 6.5% and 9.0% of those with more than 20 years of overall and abdominal obesity, respectively, compared with 5.7% and 5.3% of those who never developed overall or abdominal obesity, respectively.”

In addition, CAC was more likely to have progressed in people who had had overall and abdominal obesity for 20 years or longer, than among the non-obese.

The study’s authors concluded: “In this study a longer duration of overall and abdominal obesity beginning in young adulthood was associated with CAC and its 10-year progression through middle age independent of the degree of adiposity.

“These findings suggest that the longer duration of exposure to excess adiposity as a result of the obesity epidemic and an earlier age at onset will have important implications on the future burden of coronary atherosclerosis and potentially on the rates of clinical cardiovascular disease in the United States.”

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