Body Mass Index and Vascular Disease in Men Aged 65 Years and Over: HIMS (Health In Men Study)

Ben Lacey, Bu B. Yeap, Jonathan Golledge, Sarah Lewington, Kieran A. McCaul, Paul E. Norman, Leon Flicker, Osvaldo P. Almeida, Graeme J. Hankey

Research output: Contribution to journalArticle

Abstract

Background-Understanding the relationship between body mass index (BMI) and vascular disease at older age has become increasingly important in the many countries where both average age and BMI are rising.

Methods and Results-In this prospective cohort study, 12 203 men (aged >= 65) were recruited in 1996-1999 from the general population in Perth, Australia. To limit reverse causality, analyses excluded those with past vascular disease and the first 4 years of follow-up. During a further 8 (SD3) years of follow-up, there were 1136 first-ever major vascular events (nonfatal myocardial infarction, nonfatal stroke, or death from any vascular cause). Cox regression (adjusted for age, education, and smoking) related BMI at recruitment to incidence of major vascular events. At ages 65 to 94, the lowest risk of major vascular events was at approximate to 22.5 to 25 kg/m(2). In the higher BMI range (>= 25 kg/m(2)), 5 kg/m(2) higher BMI was associated with 33% higher risk of major vascular events (hazard ratio, 1.33 [95% confidence interval, 1.18-1.49]): 24% higher risk of ischemic heart disease (1.24 [1.06-1.46]); 34% higher risk of stroke (1.34 [1.11-1.63]); and 78% higher risk of other vascular death (1.78 [1.32-2.41]). In the lower BMI range, there were fewer events and no strong evidence of an association (hazard ratio per 5 kg/m(2) higher BMI, 0.82 [95% confidence interval, 0.61-1.12]).

Conclusions-In this population of older men, risk of major vascular events was lowest at approximate to 22.5 to 25 kg/m(2). Above this range, BMI was strongly related to incidence of major vascular events, with each 5 kg/m(2) higher BMI associated with approximate to 30% higher risk.

Original languageEnglish
Article numbere007343
Number of pages19
JournalJournal of the American Heart Association
Volume6
Issue number12
DOIs
Publication statusPublished - Dec 2017

Cite this

@article{74a8071e509642b6819d483b93ea4d82,
title = "Body Mass Index and Vascular Disease in Men Aged 65 Years and Over: HIMS (Health In Men Study)",
abstract = "Background-Understanding the relationship between body mass index (BMI) and vascular disease at older age has become increasingly important in the many countries where both average age and BMI are rising.Methods and Results-In this prospective cohort study, 12 203 men (aged >= 65) were recruited in 1996-1999 from the general population in Perth, Australia. To limit reverse causality, analyses excluded those with past vascular disease and the first 4 years of follow-up. During a further 8 (SD3) years of follow-up, there were 1136 first-ever major vascular events (nonfatal myocardial infarction, nonfatal stroke, or death from any vascular cause). Cox regression (adjusted for age, education, and smoking) related BMI at recruitment to incidence of major vascular events. At ages 65 to 94, the lowest risk of major vascular events was at approximate to 22.5 to 25 kg/m(2). In the higher BMI range (>= 25 kg/m(2)), 5 kg/m(2) higher BMI was associated with 33{\%} higher risk of major vascular events (hazard ratio, 1.33 [95{\%} confidence interval, 1.18-1.49]): 24{\%} higher risk of ischemic heart disease (1.24 [1.06-1.46]); 34{\%} higher risk of stroke (1.34 [1.11-1.63]); and 78{\%} higher risk of other vascular death (1.78 [1.32-2.41]). In the lower BMI range, there were fewer events and no strong evidence of an association (hazard ratio per 5 kg/m(2) higher BMI, 0.82 [95{\%} confidence interval, 0.61-1.12]).Conclusions-In this population of older men, risk of major vascular events was lowest at approximate to 22.5 to 25 kg/m(2). Above this range, BMI was strongly related to incidence of major vascular events, with each 5 kg/m(2) higher BMI associated with approximate to 30{\%} higher risk.",
keywords = "adiposity, body mass index, epidemiology, ischemic heart disease, stroke, vascular disease, CARDIOVASCULAR-DISEASE, MEASUREMENT ERROR, RELATIVE RISK, OBESITY, OVERWEIGHT, PARTICIPANTS, MORTALITY, SURVIVAL, VALIDITY, DATABASE",
author = "Ben Lacey and Yeap, {Bu B.} and Jonathan Golledge and Sarah Lewington and McCaul, {Kieran A.} and Norman, {Paul E.} and Leon Flicker and Almeida, {Osvaldo P.} and Hankey, {Graeme J.}",
year = "2017",
month = "12",
doi = "10.1161/JAHA.117.007343",
language = "English",
volume = "6",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "John Wiley & Sons",
number = "12",

}

Body Mass Index and Vascular Disease in Men Aged 65 Years and Over : HIMS (Health In Men Study). / Lacey, Ben; Yeap, Bu B.; Golledge, Jonathan; Lewington, Sarah; McCaul, Kieran A.; Norman, Paul E.; Flicker, Leon; Almeida, Osvaldo P.; Hankey, Graeme J.

In: Journal of the American Heart Association, Vol. 6, No. 12, e007343, 12.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Body Mass Index and Vascular Disease in Men Aged 65 Years and Over

T2 - HIMS (Health In Men Study)

AU - Lacey, Ben

AU - Yeap, Bu B.

AU - Golledge, Jonathan

AU - Lewington, Sarah

AU - McCaul, Kieran A.

AU - Norman, Paul E.

AU - Flicker, Leon

AU - Almeida, Osvaldo P.

AU - Hankey, Graeme J.

PY - 2017/12

Y1 - 2017/12

N2 - Background-Understanding the relationship between body mass index (BMI) and vascular disease at older age has become increasingly important in the many countries where both average age and BMI are rising.Methods and Results-In this prospective cohort study, 12 203 men (aged >= 65) were recruited in 1996-1999 from the general population in Perth, Australia. To limit reverse causality, analyses excluded those with past vascular disease and the first 4 years of follow-up. During a further 8 (SD3) years of follow-up, there were 1136 first-ever major vascular events (nonfatal myocardial infarction, nonfatal stroke, or death from any vascular cause). Cox regression (adjusted for age, education, and smoking) related BMI at recruitment to incidence of major vascular events. At ages 65 to 94, the lowest risk of major vascular events was at approximate to 22.5 to 25 kg/m(2). In the higher BMI range (>= 25 kg/m(2)), 5 kg/m(2) higher BMI was associated with 33% higher risk of major vascular events (hazard ratio, 1.33 [95% confidence interval, 1.18-1.49]): 24% higher risk of ischemic heart disease (1.24 [1.06-1.46]); 34% higher risk of stroke (1.34 [1.11-1.63]); and 78% higher risk of other vascular death (1.78 [1.32-2.41]). In the lower BMI range, there were fewer events and no strong evidence of an association (hazard ratio per 5 kg/m(2) higher BMI, 0.82 [95% confidence interval, 0.61-1.12]).Conclusions-In this population of older men, risk of major vascular events was lowest at approximate to 22.5 to 25 kg/m(2). Above this range, BMI was strongly related to incidence of major vascular events, with each 5 kg/m(2) higher BMI associated with approximate to 30% higher risk.

AB - Background-Understanding the relationship between body mass index (BMI) and vascular disease at older age has become increasingly important in the many countries where both average age and BMI are rising.Methods and Results-In this prospective cohort study, 12 203 men (aged >= 65) were recruited in 1996-1999 from the general population in Perth, Australia. To limit reverse causality, analyses excluded those with past vascular disease and the first 4 years of follow-up. During a further 8 (SD3) years of follow-up, there were 1136 first-ever major vascular events (nonfatal myocardial infarction, nonfatal stroke, or death from any vascular cause). Cox regression (adjusted for age, education, and smoking) related BMI at recruitment to incidence of major vascular events. At ages 65 to 94, the lowest risk of major vascular events was at approximate to 22.5 to 25 kg/m(2). In the higher BMI range (>= 25 kg/m(2)), 5 kg/m(2) higher BMI was associated with 33% higher risk of major vascular events (hazard ratio, 1.33 [95% confidence interval, 1.18-1.49]): 24% higher risk of ischemic heart disease (1.24 [1.06-1.46]); 34% higher risk of stroke (1.34 [1.11-1.63]); and 78% higher risk of other vascular death (1.78 [1.32-2.41]). In the lower BMI range, there were fewer events and no strong evidence of an association (hazard ratio per 5 kg/m(2) higher BMI, 0.82 [95% confidence interval, 0.61-1.12]).Conclusions-In this population of older men, risk of major vascular events was lowest at approximate to 22.5 to 25 kg/m(2). Above this range, BMI was strongly related to incidence of major vascular events, with each 5 kg/m(2) higher BMI associated with approximate to 30% higher risk.

KW - adiposity

KW - body mass index

KW - epidemiology

KW - ischemic heart disease

KW - stroke

KW - vascular disease

KW - CARDIOVASCULAR-DISEASE

KW - MEASUREMENT ERROR

KW - RELATIVE RISK

KW - OBESITY

KW - OVERWEIGHT

KW - PARTICIPANTS

KW - MORTALITY

KW - SURVIVAL

KW - VALIDITY

KW - DATABASE

U2 - 10.1161/JAHA.117.007343

DO - 10.1161/JAHA.117.007343

M3 - Article

VL - 6

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 12

M1 - e007343

ER -