Home > Uncategorized > Body Mass Index in Adolescence and Long term Cardiovascular Mortality

Body Mass Index in Adolescence and Long term Cardiovascular Mortality

Twig et al report a longitudinal study of 2.3 million Israeli adolescents from 1967 to 2010. Body mass index regarded as normal (50th to 74th percentile) was associated with higher long term cardiovascular mortality (reference group 5th to 24th percentile).

Summary

BACKGROUND

In light of the worldwide increase in childhood obesity, we examined the association between body-mass index (BMI) in late adolescence and death from cardiovascular causes in adulthood.

METHODS

We grouped data on BMI, as measured from 1967 through 2010 in 2.3 million
Israeli adolescents (mean age, 17.3±0.4 years), according to age- and sex-specific percentiles from the U.S. Centers for Disease Control and Prevention. Primary outcomes were the number of deaths attributed to coronary heart disease, stroke, sudden death from an unknown cause, or a combination of all three categories (total cardiovascular causes) by mid-2011. Cox proportional-hazards models were used.

RESULTS

During 42,297,007 person-years of follow-up, 2918 of 32,127 deaths (9.1%) were
from cardiovascular causes, including 1497 from coronary heart disease, 528 from
stroke, and 893 from sudden death. On multivariable analysis, there was a graded
increase in the risk of death from cardiovascular causes and all causes that started among participants in the group that was in the 50th to 74th percentiles of BMI (i.e., within the accepted normal range). Hazard ratios in the obese group (≥95th percentile for BMI), as compared with the reference group in the 5th to 24th percentiles, were 4.9 (95% confidence interval [CI], 3.9 to 6.1) for death from coronary heart disease, 2.6 (95% CI, 1.7 to 4.1) for death from stroke, 2.1 (95% CI, 1.5 to 2.9) for sudden death, and 3.5 (95% CI, 2.9 to 4.1) for death from total cardiovascular
causes, after adjustment for sex, age, birth year, sociodemographic characteristics,and height. Hazard ratios for death from cardiovascular causes in the same percentile groups increased from 2.0 (95% CI, 1.1 to 3.9) during follow-up for 0 to 10 years to 4.1 (95% CI, 3.1 to 5.4) during follow-up for 30 to 40 years; during both periods, hazard ratios were consistently high for death from coronary heart disease. Findings persisted in extensive sensitivity analyses.
CONCLUSIONS
A BMI in the 50th to 74th percentiles, within the accepted normal range, during adolescence was associated with increased cardiovascular and all-cause mortality during 40 years of follow-up. Overweight and obesity were strongly associated with increased cardiovascular mortality in adulthood.

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