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Estimating the risk of cardiovascular disease using an obese-years metric

Abdullah, Asnawi, Amin, Fauzi Ali, Stoelwinder, Johannes, Tanamas, Stephanie K., Wolfe, Rory, Barendregt, Jan and Peeters, Anna 2014, Estimating the risk of cardiovascular disease using an obese-years metric, BMJ open, vol. 4, no. 9, Article number : e005629, pp. 1-9, doi: 10.1136/bmjopen-2014-005629.

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Title Estimating the risk of cardiovascular disease using an obese-years metric
Author(s) Abdullah, Asnawi
Amin, Fauzi Ali
Stoelwinder, Johannes
Tanamas, Stephanie K.
Wolfe, Rory
Barendregt, Jan
Peeters, AnnaORCID iD for Peeters, Anna orcid.org/0000-0003-4340-9132
Journal name BMJ open
Volume number 4
Issue number 9
Season Article number : e005629
Start page 1
End page 9
Total pages 9
Publisher BMJ Publishing Group
Place of publication London, Eng.
Publication date 2014
ISSN 2044-6055
Keyword(s) EPIDEMIOLOGY
NUTRITION & DIETETICS
PUBLIC HEALTH
VASCULAR MEDICINE
Adult
Cardiovascular Diseases
Female
Humans
Male
Middle Aged
Obesity
Prospective Studies
Risk Assessment
Time Factors
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
MORTALITY
DURATION
HEALTH
MODEL
Summary OBJECTIVE: To examine the association between obese-years and the risk of cardiovascular disease (CVD).

STUDY DESIGN: Prospective cohort study.

SETTING: Boston, USA.

PARTICIPANTS: 5036 participants of the Framingham Heart Study were examined.

METHODS: Obese-years was calculated by multiplying for each participant the number of body mass index (BMI) units above 29 kg/m(2) by the number of years lived at that BMI during approximately 50 years of follow-up. The association between obese-years and CVD was analysed using time-dependent Cox regression adjusted for potential confounders and compared with other models using the Akaike information criterion (AIC). The lowest AIC indicated better fit.

PRIMARY OUTCOME CVD RESULTS: The median cumulative obese-years was 24 (range 2-556 obese-years). During 138,918 person-years of follow-up, 2753 (55%) participants were diagnosed with CVD. The incidence rates and adjusted HR (AHR) for CVD increased with an increase in the number of obese-years. AHR for the categories 1-24.9, 25-49.9, 50-74.9 and ≥75 obese-years were, respectively, 1.31 (95% CI 1.15 to 1.48), 1.37 (95% CI 1.14 to 1.65), 1.62 (95% CI 1.32 to 1.99) and 1.80 (95% CI 1.54 to 2.10) compared with those who were never obese (ie, had zero obese-years). The effect of obese-years was stronger in males than females. For every 10 unit increase in obese-years, the AHR of CVD increased by 6% (95% CI 4% to 8%) for males and 3% (95% CI 2% to 4%) for females. The AIC was lowest for the model containing obese-years compared with models containing either the level of BMI or the duration of obesity alone.

CONCLUSIONS: This study demonstrates that obese-years metric conceptually captures the cumulative damage of obesity on body systems, and is found to provide slightly more precise estimation of the risk of CVD than the level or duration of obesity alone.
Language eng
DOI 10.1136/bmjopen-2014-005629
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30078857

Document type: Journal Article
Collections: School of Health and Social Development
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.