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Longer obesity duration raises risk of subclinical heart disease

Wednesday July 17, 2013
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In a study of adults recruited and followed up over the past three decades in the United States, longer duration of overall and abdominal obesity beginning in young adulthood was associated with higher rates of coronary artery calcification, a subclinical predictor of coronary heart disease.

"With a doubling of obesity rates for adults and a tripling of rates for adolescents during the last three decades, younger individuals are experiencing a greater cumulative exposure to excess adiposity during their lifetime," according to background information for the study, which appears in the July 17 issue of the Journal of the American Medical Association. "However, few studies have determined the consequences of long-term obesity."

Jared P. Reis, PhD, of the National Heart, Lung, and Blood Institute in Bethesda, Md., and colleagues conducted a study to investigate whether the duration of overall and abdominal obesity was associated with the presence and 10-year progression of coronary artery calcification. The study included 3,275 white and black adults who were ages 18 to 30 at the beginning of the study period, in 1985-86, and who did not initially have overall obesity or abdominal obesity. Participants came from the multicenter, community-based Coronary Artery Risk Development in Young Adults study.

The researchers found that the presence and extent of coronary artery calcification were associated with duration of overall and abdominal obesity. Of participants with more than 20 years of overall obesity and abdominal obesity, about 38.2% and 39.3%, respectively, had coronary artery calcification. Among those who never developed overall or abdominal obesity, the rates of CAC were 24.9% and 24.7%, respectively.

Coronary artery calcification that was deemed "extensive" was present in 6.5% and 9% of participants with more than 20 years of overall or abdominal obesity, respectively, compared with 5.7% and 5.3% of those who never developed overall or abdominal obesity.

Approximately 25.2% and 27.7% of those with more than 20 years of overall and abdominal obesity, respectively, experienced progression of coronary artery calcification over 10 years, compared with 20.2% and 19.5% of those with no years of obesity.

"In this study a longer duration of overall and abdominal obesity beginning in young adulthood was associated with CAC and its 10-year progression through middle age independent of the degree of adiposity," the authors concluded. "These findings suggest that the longer duration of exposure to excess adiposity as a result of the obesity epidemic and an earlier age at onset will have important implications on the future burden of coronary atherosclerosis and potentially on the rates of clinical cardiovascular disease in the United States."

Read the study abstract: http://jama.jamanetwork.com/article.aspx?articleid=1713590.


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