Cohort study of effect of being overweight and change in weight on risk of coronary heart disease in old age.
OBJECTIVE
To evaluate risk of late life coronary heart disease associated with being overweight in late middle or old age and to assess whether weight change modifies this risk.


METHODS
Longitudinal study of subjects in the epidemiological follow up study of the national health and nutrition examination survey I.


METHODS
United States.


METHODS
621 men and 960 women free of coronary heart disease in 1982-84 (mean age 77 years).


METHODS
Incidence of coronary heart disease.


RESULTS
Body mass index of 27 or more in late middle age was associated with increased risk of coronary heart disease in late life (relative risk = 1.7 (95% confidence interval 1.3 to 2.1)) while body mass index of 27 or more in old age was not (1.1 (0.8 to 1.5)). This difference in risk was due largely to weight loss between middle and old age. Exclusion of those with weight loss of 10% or more increased risk associated with heavier weight in old age (1.4 (1.0 to 1.9)). Thinner older people who lost weight and heavier people who had gained weight showed increased risk of coronary heart disease compared with thinner people with stable weight.


CONCLUSIONS
Heavier weight in late middle age was a risk factor for coronary heart disease in late life. Heavier weight in old age was associated with an increased risk once those with substantial weight loss were excluded. The contribution of weight to risk of coronary heart disease in older people may be underestimated if weight history is neglected.
Harris
T B
TB
Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, MD, USA. harrist@gw.nia.nih.gov
Launer
L J
LJ
Madans
J
J
Feldman
J J
JJ
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D015430:Weight Gain; D015431:Weight Loss