Diabetes, body mass index and the excess risk of coronary heart disease, ischemic and hemorrhagic stroke in the Asia Pacific Cohort Studies Collaboration

Objective: To examine the effects of diabetes on coronary heart disease, ischemic and hemorrhagic stroke and cardiovascular disease according to category of body mass index. Methods: Data on 161,161 men and women from 31 cohorts (baseline years, 1966-99; mean follow-up, 2-24. years) from the Asia Pacific Cohort Studies Collaboration were analyzed using Cox regression, stratified by sex and study and adjusted for age, systolic blood pressure and smoking. Diabetes was self-reported in all but one study. Body mass index was divided into five categories according to the World Health Organization Asian criteria. Results: The hazard ratio (diabetes v. not) for cardiovascular disease was 1.83 (95% confidence interval, 1.66-2.01). Across body mass index categories, this hazard ratio did not change significantly (p = 0.19). Similar lack of difference across body mass index groups was found for coronary heart disease (p = 0.33), ischemic stroke (p = 0.97) and hemorrhagic stroke (p = 0.98). Conclusions: Body mass index does not modify the effect of diabetes on major cardiovascular outcomes.