Friday, November 15, 2013
Weight alone could be a significant risk factor for heart attack and heart disease, regardless of whether a person also has metabolic syndrome, a cluster of conditions that includes high blood pressure, blood sugar or cholesterol, a new JAMA Internal Medicine study suggests.
Researchers from Herlev Hospital in Denmark examined data from 71,527 people who were part of the Copenhagen General Population Study over nearly four years. During this time period, there were 634 heart attacks and 1,781 cases of ischemic heart disease.
Interestingly enough, overweight and obesity increased the risk of heart attack the same amount regardless of whether a person also had metabolic syndrome, compared with people of normal weight.
"Our findings suggest that metabolic syndrome is no more valuable than BMI in identifying individuals at risk of ischemic cardiovascular disease and may call into question the overall clinical utility of metabolic syndrome in overweight and obese individuals," the researchers wrote in the study.
They noted that one possible explanation for the finding is that overweight and obese people who did not have metabolic syndrome at the start of the study developed aspects of metabolic syndrome over time, which eventually led to them experiencing the cardiovascular event.
"In support of this hypothesis, abdominal obesity often precedes the other components and may even be causal in the development of other cardiovascular risk factors such as hypertension," they wrote.
In a related commentary, experts from the Harvard School of Public Health and Harvard Medical School noted that the findings are surprising considering it's a common belief that people who are metabolically healthy -- even if overweight or obese -- don't face additional consequential health risks.
"Besides questions related to how much added value there is to assessing MetS [metabolic syndrome] (beyond its component elements), the findings from this study have important implications and clearly corroborate the clinical and public health message that adiposity is not benign and that achieving and maintaining a healthy body weight (typically, BMI, >18.5 to <25.0 kg/m2) is of paramount importance," they wrote in the commentary.
Thomsen M, Nordestgaard BG. Myocardial Infarction and Ischemic Heart Disease in Overweight and Obesity With and Without Metabolic Syndrome. JAMA Intern Med.2013