Relation of longitudinal changes in body mass index with atherosclerotic cardiovascular disease risk scores in middle-aged black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Abstract

PURPOSE We assessed whether longitudinal changes in body mass index (BMI) is positively associated with changes in 10-year AHA/ACC atherosclerotic cardiovascular disease (ASCVD) risk scores in middle-aged blacks compared to whites. METHODS Data were from 1,691 participants enrolled in CARDIA aged ≥40 years in 2000–2001, who had follow-up exams 5 and 10 years later. RESULTS The prevalence of obesity increased from 32.3% in 2000–2001(mean age: 42.8 years) to 41.7% in 2010–2011, higher in blacks than whites. The corresponding change in 10-year ASCVD risk was significantly higher for blacks (men: 4.5 to 9.6%, women: 1.7 to 5.0%) than whites (men: 2.4 to 5.2%, women: 0.7 to 1.6%). In 2010–2011, 57.5% of black men had ASCVD risk scores ≥ 7.5% compared to white men (14.7%), black women (17.4 %) and white women (1.6%). Although BMI trends were positively associated with 10-year change in ASCVD risk scores (0.07% per 1 kg/m2 increase), it explained very little variance in risk score trends in all race-sex groups. CONCLUSIONS In middle-aged adults, longitudinal changes in BMI had little independent influence on changes in 10-year ASCVD risk scores as its effect may be largely mediated through ASCVD risk factors already accounted for in the risk score.

Predicted 10-year risk of cardiovascular disease in the Islamic Republic of Iran and the body mass index paradox

“…Furthermore, a study with an international cohort showed that CVD risk in obese and overweight people was not higher than those with normal BMI, and a reverse J-shaped curve persisted between BMI category and incidence of CVD outcomes (31). A longitudinal study in the United States showed that BMI had little independent influence (0.07% per 1 kg/m2 increase) on 10-year atherosclerotic CVD risk scores (32). A systematic review of 40 cohort studies found that overweight and obese people had better survival and lower CVD events (33).…”

The association between various indices of obesity and severity of atherosclerosis in adults in the north of Iran

“…Data from 1691 participants enrolled in the Coronary Artery Risk Development in Young Adults Study aged 40 years or more showed that in middle-aged adults, longitudinal changes in BMI had the little independent influence on changes in 10-year atherosclerotic cardiovascular disease risk scores as its effect may be largely mediated through risk factors already accounted for in the risk score. [ 20 ] WHtR indices could differ among sex and age groups because whole-body fat distribution and WC change considerably with age and also height differs among generations. [ 21 ] Two previous studies, in the United States and China, reported that the association between WHtR and cardiovascular disease was stronger among younger adults as compared with elderly adults.…”

Modelling of longitudinal data to predict cardiovascular disease risk: a methodological review

“…Four (10.0%) studies modelled changes in risk scores over time using linear mixed effects (LME) models, [ 33 , 44 , 46 ] for example, predicting the trajectory of the Framingham Risk Score over four time-points [ 44 ]. Fixed effects linear regression was used by one study [ 52 ] to examine how change in body mass index (BMI) is correlated with the Framingham Risk Score.…”