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Weight history predicts heart failure risk

Weight history predicts heart failure risk

Publication date: Thursday, 17 January 2019

A new study shows that asking patients simple questions about their weight at the ages of 20 and 40 provides valuable information to aid prediction of future cardiovascular disease.

The study used data already gathered on 6437 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) recruited between 2000 and 2002 who were age 45 to 84 at time of enrolment into the study. Participants were followed an average of 13 years. Each participant filled out a survey that reported their weight history at age 20 and 40. Their weights were further tracked during the study period using measurements from a standardized scale over five different in-person visits.

The study showed a 34% increase in risk of heart failure for every 5 kg/m2 in BMI during the 13-year study period after accounting for other established heart disease risk factors such as age, smoking, physical activity, blood pressure and diabetes. However, more importantly the team found that having a self-reported history of obesity at age 20 was associated with a more than threefold risk of heart failure, and having a history of being obese at age 40 doubled the risk compared with people who had a BMI in the normal range at those ages.

After adjustment for cardiovascular risk factors and baseline BMI, higher self‐reported weights at ages 20 and 40 years were independently associated with increased risk of incident heart failure per 5 kg/m2 higher BMI.

  • At 20 years – HR (95% CI) 1.27 (1.07–1.50)
  • At 40 years - HR (95% CI) 1.36 (1.18–1.57)

ACTION

The study confirms that maintaining a normal weight throughout a person’s lifespan minimises the risk of cardiovascular disease and healthcare professionals should maintain this message. Self-reported lifetime weight is a valuable low-tech tool that can be used in this approach. 

Fliotsos M, et al. Body Mass Index from early-, mid- and older adulthood and risk of heart failure and atherosclerotic cardiovascular disease. Journal of the American Heart Association 2018;7:e009599  https://www.ahajournals.org/doi/10.1161/JAHA.118.009599

 

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Topics covered:
Category: Evidence in Practice
Edition: Volume 4 Number 1 PCCJ Online 2019

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