Expanding Waistline Hurts Your Heart

More fat means earlier attacks, study says

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HealthDay Reporter

WEDNESDAY, Aug. 1, 2001 (HealthDayNews) -- Fat people have heart attacks earlier than those of normal weight, a new study finds. And the fatter you are, the sooner you can expect one.

That frightening relationship holds true regardless of other risk factors for heart disease, such as diabetes, smoking and high blood pressure, say cardiologists at the Mayo Clinic. Their findings appear in August issue of Clinical Cardiology.

The measure they used was the body mass index (BMI), a standard way of assessing weight. BMI is a person's weight in kilograms divided by the square of height in meters. Someone with a BMI between 25 and 30 is considered overweight, while someone with a BMI of 30 or more is obese.

In the decade-long study, the Mayo doctors looked at 906 patients admitted to a hospital emergency room in Minnesota with heart attacks between April 1988 and March 1990. Roughly a third of the patients, or 306, had BMIs of 24.9 or less, while 362 were overweight and 238 were obese.

The average age of the heart attack patients of normal weight was 72.9 years, compared to 66.9 years for the overweight patients and 62.3 years for the obese patients. That's "a highly significant correlation between BMI and age at presentation with acute myocardial infarct [heart attack]," the researchers say.

The overweight and obese patients were more likely to have the well-known risk factors for heart disease, such as smoking, high blood pressure, high cholesterol levels and diabetes, says lead author Dr. R. Scott Wright.

"But we did a multivariate analysis to adjust for all those characteristics and found that the overweight patients had their heart attacks 3.6 years earlier than those of normal weight, and the obese patients were 8.2 years younger," he says.

Other research has hinted at a relationship between weight and age of heart attack incidence, "but to our knowledge, no study has definitively examined whether obese patients come in at an earlier age," he says.

"This gives new evidence for a well-established relationship," says Dr. Arthur T. Davidson Jr., president-elect of the American Society of Bariatric Physicians, specialists in weight control. "The study is right on the money."

One way fat leads to heart disease is that it increases insulin levels, Davidson says. High insulin levels tend to raise blood pressure, and "when you take weight off, insulin levels go down," he says.

Obesity is common in the United States, Wright says, noting the Centers for Disease Control and Prevention call it "a critical public health concern." But he says too many people won't accept they are part of the problem precisely because obesity is so prevalent.

"When we look at our neighbors, we tend to feel that we are all right because we look like them, but perhaps all of us are overweight," Wright says.

What To Do

Anyone with a BMI of 25 or more should see a doctor and start a weight-loss plan that includes diet and exercise, Wright says.

A BMI calculator is offered by the Mayo Clinic.

The American Heart Association has these tips to lose weight.

SOURCES: Interviews with R. Scott Wright, M.D., senior associate consultant, cardiology, Mayo Clinic, Rochester, Minn.; Arthur T. Davidson Jr., M.D., president-elect, American Society of Bariatric Physicians, New York City; August 2001 Clinical Cardiology

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