Trends in cardiovascular disease risk factors by body mass index category among adults in England 2003-18: analysis of repeated cross-sectional national health surveys

Abstract

Objective. Favourable trends in cardiovascular disease (CVD) risk factors at the population level potentially mask differences within high- and low-risk groups. Data from annual, repeated cross-sectional surveys (Health Survey for England 2003-18) was used to examine trends in the prevalence of key CVD risk factors by body mass index (BMI) category among adults aged 16 years or older (n=115,860). Methods. Six risk factors were investigated: (i) current cigarette smoking; (ii) physical inactivity (<30 minutes of moderate-to-vigorous physical activity per week); (iii) drinking above recommended daily alcohol limits; (iv) hypertension (measured blood pressure ≥140/90mmHg or use of medicine prescribed for high blood pressure); (v) total diabetes (reported diagnosed or elevated glycated haemoglobin); and (vi) raised total cholesterol (≥5mmol/L). Age-standardised risk factor prevalence was computed in each four-year time period (2003-06; 2007-10; 2011-14; 2015-18) in all adults and by BMI category (normal-weight; overweight; obesity). Change in risk factor prevalence on the absolute scale was computed as the difference between the first and last time-periods, expressed in percentage points (PP). Results. Risk factor change varied by BMI category in a number of cases. Current smoking prevalence fell more sharply for normal-weight men (-8.1 PP; 95% CI: -10.3, -5.8) versus men with obesity (-3.8 PP; 95% CI: -6.2, -1.4). Hypertension remained at a stable level among normal-weight men but decreased among men with obesity (-4.1 PP; 95% CI: -7.1, -1.0). Total diabetes remained at a stable level among normal-weight adults, but increased among adults with obesity (men: 3.5 PP; 95% CI: 1.2, 5.7; women: 3.6 PP; 95% CI: 1.8, 5.4). Raised total cholesterol decreased in all BMI groups, but fell more sharply among women with obesity (-21 PP; 95% CI: -25, -17) versus their normal-weight counterparts (-16 PP; 95% CI: -18, -14). Conclusions. Relative to adults with normal weight, greater reductions in hypertension and raised total cholesterol among adults with overweight and obesity reflect at least in part improvements in screening, treatment and control among those at highest cardiovascular risk. Higher levels of risk factor prevalence among adults with overweight and obesity, in parallel with rising diabetes, highlight the importance of national prevention efforts to combat the public health impact of excess adiposity.

Trends in body mass index and blood pressure associations from 1989 to 2018: co-ordinated analysis of 145,399 participants

“…22 23 Recent public health initiatives in the UK have included screening programmes for higher BP levels amongst those at highest CVD risk, 43 44 leading to increases in hypertension diagnosis and treatment amongst those with high BMI. 45 While treatment has increased, as observed in our data, it has seemingly had a modest effect on BMI and BP associations, particularly in younger age groups. This is evidenced by 1) our analysis accounting for treatment, and 2) quantile regression analyses suggesting that much of the association between BMI and SBP is present below the 140mmHg threshold for hypertension treatment.…”

Association between fast-food consumption and the risk of developing coronary heart disease among the male population in Peshawar

“…According to the findings of the INTERHEART as well as INTERSTROKE studies, the leading global risk variables of myocardial infarction, also known as stroke, include high blood pressure, type 2 diabetes, dyslipidemia, being overweight or obese, cigarette smoking, insufficient regular exercise, poor diet, as well as excessive alcohol use [20,21]. Obesity has proved linked to a variety of negative health effects, including high blood pressure, diabetes, heart disease, joint discomfort, mobility issues, and even death [22]. Two times weekly use of Western-style fast food was associated with a higher likelihood of developing type 2 diabetes (TIIDM) as well as increased mortality from (CHD) in Chinese as well as Singaporean adults [23].…”

Epigenetic Regulation of Macrophage Polarization in Cardiovascular Diseases

“…Arterial hypertension, alcoholism, cholesterolemia, diabetes mellitus, obesity, and smoking are the most common risk factors associated with CVDs [ 4 ]. Furthermore, infection and inflammatory conditions increase the risk of CVDs.…”