© 1996 American Heart Association, Inc.
Articles |
Impact of Body Mass Index on Coronary Heart Disease Risk Factors in Men and Women
The Framingham Offspring Study
the Lipid Metabolism Laboratory (S.L.-F., E.J.S.), Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, and the Framingham Study (P.W.F.W.), Epidemiology Biometry Program, Framingham, Mass.
Correspondence to Stefania Lamon-Fava, MD, PhD, Lipid Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111. E-mail Fava LI@HNRC.Tufts.edu.
Increased body weight has been associated with an increased risk of morbidity and mortality from coronary heart disease (CHD) in several populations. We studied the distribution of body mass index (BMI, kg/m2) in men (n=1566; mean age, 49±10 years) and women (n=1627; mean age, 49±10 years) participating in the third examination cycle of the Framingham Offspring Study and the association of BMI with known CHD risk factors. In men, BMI increased with age until age 50 years, when it reached a plateau. In women, there was a trend toward an increase in BMI with age up to the seventh decade of life. Seventy-two percent of men and 42% of women had a BMI 
25.00, the cutoff point for the definition of overweight. In age-adjusted analyses, BMI was significantly and linearly associated with systolic blood pressure, fasting glucose levels, plasma total cholesterol, VLDL cholesterol, and LDL cholesterol levels and was inversely and linearly associated with HDL cholesterol levels (P<.001) in nonsmoking men and women. The association between BMI and apolipoprotein B and A-I was similar to that of LDL and HDL cholesterol, respectively. LDL size was also linearly associated with BMI: subjects with higher BMI had smaller LDL particles. Lipoprotein(a) levels were not associated with BMI in this population. Of all these risk factors for CHD, reduced HDL cholesterol levels and hypertension were those more strongly associated with higher BMI in both men and women. Elevated triglyceride levels and small LDL particles, and diabetes in women, were also strongly associated with higher BMI values in this population. Our results indicate that a high prevalence of adult Americans are overweight and support the concept that increased BMI is associated with an adverse effect on all major CHD risk factors. These results emphasize the importance of excess body fat as a public health issue.
Key Words: body mass index • coronary heart disease • lipoproteins • cholesterol • blood pressure • diabetes mellitus
This article has been cited by other articles:
 |
|
 |
|
  N. C. Cavarocchi Invited commentary. Ann. Thorac. Surg., February 1, 2009; 87(2): 546 - 547. [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. Chiuve, M. L. McCullough, F. M. Sacks, and E. B. Rimm Healthy Lifestyle Factors in the Primary Prevention of Coronary Heart Disease Among Men: Benefits Among Users and Nonusers of Lipid-Lowering and Antihypertensive Medications Circulation, July 11, 2006; 114(2): 160 - 167. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. J. Shaw, C. N. Bairey Merz, C. J. Pepine, S. E. Reis, V. Bittner, S. F. Kelsey, M. Olson, B. D. Johnson, S. Mankad, B. L. Sharaf, et al. Insights From the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part I: Gender Differences in Traditional and Novel Risk Factors, Symptom Evaluation, and Gender-Optimized Diagnostic Strategies J. Am. Coll. Cardiol., February 7, 2006; 47(3_Suppl_S): S4 - S20. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Wilsgaard, B. K. Jacobsen, and E. Arnesen Determining Lifestyle Correlates of Body Mass Index using Multilevel Analyses: The Tromso Study, 1979-2001 Am. J. Epidemiol., December 15, 2005; 162(12): 1179 - 1188. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. M. Yalcin, E. M. Sahin, and E. Yalcin Which anthropometric measurements is most closely related to elevated blood pressure? Fam. Pract., October 1, 2005; 22(5): 541 - 547. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Lamon-Fava, J. B. Barnett, M. N. Woods, C. McCormack, J. R. McNamara, E. J. Schaefer, C. Longcope, B. Rosner, and S. L. Gorbach Differences in Serum Sex Hormone and Plasma Lipid Levels in Caucasian and African-American Premenopausal Women J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4516 - 4520. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. C. St-Pierre, B. Cantin, P. Mauriege, J. Bergeron, G. R. Dagenais, J.-P. Despres, and B. Lamarche Insulin resistance syndrome, body mass index and the risk of ischemic heart disease Can. Med. Assoc. J., May 10, 2005; 172(10): 1301 - 1305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Mora, L. R. Yanek, T. F. Moy, M. D. Fallin, L. C. Becker, and D. M. Becker Interaction of Body Mass Index and Framingham Risk Score in Predicting Incident Coronary Disease in Families Circulation, April 19, 2005; 111(15): 1871 - 1876. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Oh, F. B. Hu, J. E. Manson, M. J. Stampfer, and W. C. Willett Dietary Fat Intake and Risk of Coronary Heart Disease in Women: 20 Years of Follow-up of the Nurses' Health Study Am. J. Epidemiol., April 1, 2005; 161(7): 672 - 679. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. L Pelkman, V. K Fishell, D. H Maddox, T. A Pearson, D. T Mauger, and P. M Kris-Etherton Effects of moderate-fat (from monounsaturated fat) and low-fat weight-loss diets on the serum lipid profile in overweight and obese men and women Am. J. Clinical Nutrition, February 1, 2004; 79(2): 204 - 212. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Wolk, P. Berger, R. J. Lennon, E. S. Brilakis, and V. K. Somers Body Mass Index: A Risk Factor for Unstable Angina and Myocardial Infarction in Patients With Angiographically Confirmed Coronary Artery Disease Circulation, November 4, 2003; 108(18): 2206 - 2211. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L Shapo, J Pomerleau, and M McKee Epidemiology of hypertension and associated cardiovascular risk factors in a country in transition: a population based survey in Tirana City, Albania J Epidemiol Community Health, September 1, 2003; 57(9): 734 - 739. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. N. Reeds, B. Mittendorfer, B. W. Patterson, W. G. Powderly, K. E. Yarasheski, and S. Klein Alterations in lipid kinetics in men with HIV-dyslipidemia Am J Physiol Endocrinol Metab, September 1, 2003; 285(3): E490 - E497. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Zhu, Z. Wang, W. Shen, S. B Heymsfield, and S. Heshka Percentage body fat ranges associated with metabolic syndrome risk: results based on the third National Health and Nutrition Examination Survey (1988-1994) Am. J. Clinical Nutrition, August 1, 2003; 78(2): 228 - 235. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Mittendorfer, B. W. Patterson, S. Klein, and L. S. Sidossis VLDL-triglyceride kinetics during hyperglycemia-hyperinsulinemia: effects of sex and obesity Am J Physiol Endocrinol Metab, April 1, 2003; 284(4): E708 - E715. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Mittendorfer, B. W Patterson, and S. Klein Effect of sex and obesity on basal VLDL-triacylglycerol kinetics Am. J. Clinical Nutrition, March 1, 2003; 77(3): 573 - 579. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Mittendorfer, B. W. Patterson, and S. Klein Effect of weight loss on VLDL-triglyceride and apoB-100 kinetics in women with abdominal obesity Am J Physiol Endocrinol Metab, March 1, 2003; 284(3): E549 - E556. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. W. F. Wilson, R. B. D'Agostino, L. Sullivan, H. Parise, and W. B. Kannel Overweight and Obesity as Determinants of Cardiovascular Risk: The Framingham Experience Arch Intern Med, September 9, 2002; 162(16): 1867 - 1872. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.F. Ebenbichler, M. Laimer, S. Kaser, A. Ritsch, A. Sandhofer, H. Weiss, F. Aigner, and J.R. Patsch Relationship Between Cholesteryl Ester Transfer Protein and Atherogenic Lipoprotein Profile in Morbidly Obese Women Arterioscler. Thromb. Vasc. Biol., September 1, 2002; 22(9): 1465 - 1469. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. J Schaefer Lipoproteins, nutrition, and heart disease Am. J. Clinical Nutrition, February 1, 2002; 75(2): 191 - 212. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. R. Gaunt, J. A. Cooper, G. J. Miller, I. N.M. Day, and S. D. O'Dell Positive associations between single nucleotide polymorphisms in the IGF2 gene region and body mass index in adult males Hum. Mol. Genet., July 1, 2001; 10(14): 1491 - 1501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Holvoet, A. Mertens, P. Verhamme, K. Bogaerts, G. Beyens, R. Verhaeghe, D. Collen, E. Muls, and F. Van de Werf Circulating Oxidized LDL Is a Useful Marker for Identifying Patients With Coronary Artery Disease Arterioscler. Thromb. Vasc. Biol., May 1, 2001; 21(5): 844 - 848. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. L. Rainwater, B. D. Mitchell, A. G. Comuzzie, J. L. VandeBerg, M. P. Stern, and J. W. MacCluer Associations among 5-Year Changes in Weight, Physical Activity, and Cardiovascular Disease Risk Factors in Mexican Americans Am. J. Epidemiol., November 15, 2000; 152(10): 974 - 982. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Olson, S. F. Kelsey, V. Bittner, S. E. Reis, N. Reichek, E. M. Handberg, C. N. Bairey Merz, and for the Women's Ischemia Syndrome Evaluation (WISE Weight cycling and high-density lipoprotein cholesterol in women: evidence of an adverse effect: A report from the NHLBI-sponsored WISE study J. Am. Coll. Cardiol., November 1, 2000; 36(5): 1565 - 1571. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E.S. Kilpatrick, B.G. Keevil, C. Jagger, R.J. Spooner, and M. Small Determinants of raised C-reactive protein concentration in type 1 diabetes QJM, April 1, 2000; 93(4): 231 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. N. Bairey Merz, S. F. Kelsey, C. J. Pepine, N. Reichek, S. E. Reis, W. J. Rogers, B. L. Sharaf, G. Sopko, and for the WISE Study Group The Women's Ischemia Syndrome Evaluation (WISE) Study: protocol design, methodology and feasibility report J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1453 - 1461. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Pietrobelli, R. C Lee, E. Capristo, R. J Deckelbaum, and S. B Heymsfield An independent, inverse association of high-density-lipoprotein-cholesterol concentration with nonadipose body mass Am. J. Clinical Nutrition, April 1, 1999; 69(4): 614 - 620. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Borson-Chazot, C. Harthe, F. Teboul, F. Labrousse, C. Gaume, L. Guadagnino, B. Claustrat, F. Berthezene, and P. Moulin Occurrence of Hyperhomocysteinemia 1 Year after Gastroplasty for Severe Obesity J. Clin. Endocrinol. Metab., February 1, 1999; 84(2): 541 - 545. [Abstract] [Full Text]
|
|
|
|
|
|
T. Rönnemaa, J. Marniemi, M. J. Savolainen, Y. A. Kesäniemi, C. Ehnholm, C. Bouchard, and M. Koskenvuo Serum Lipids, Lipoproteins, and Lipid Metabolizing Enzymes in Identical Twins Discordant for Obesity J. Clin. Endocrinol. Metab., August 1, 1998; 83(8): 2792 - 2799. [Abstract] [Full Text]
|
|