title: Age and race impact the association between BMI and CVD mortality in women.
abstract: OBJECTIVE
  In previous studies, we have shown that obesity is associated with increased cardiovascular disease (CVD) mortality in white women but not in black women. Earlier research suggests that body mass index (BMI) has a greater effect on CVD mortality in younger white females than older white females, whereas this relationship in black women is not as clear. This study examines the effect of age on the association of BMI to CVD in black and white women.
  
  
  METHODS
  The Black Pooling Project includes data on 2,843 black women with 50,464 person-years of follow-up, and 12,739 white women with 214,606 person-years of follow-up. A Cox proportional hazards model was used to examine the association between BMI and CVD mortality for specific age/race groups. The younger group was < 60 years of age and the older group was > 60 years of age.
  
  
  RESULTS
  In younger white women, the relative risk (95% confidence interval [CI]) for CVD mortality was significant in obese women (BMI > 30 kg/m2) vs. women of normal weight (BMI 18.5-24.9 kg/m2) (1.59 [CI 1.20, 2.09]). Similarly, in older white women, the relative risk for CVD mortality in obese women vs. women of normal weight was significant (1.21 [CI 1.04, 1.41]). There were no such associations for black women. Overweight (BMI 25-29.9 kg/m2) was not associated with increased risk in black or white women.
  
  
  CONCLUSIONS
  These findings indicate that obesity is associated with a significantly greater risk of CVD mortality among white women, with the strongest association among white women < 60 years of age.
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA. jill.e.abell@gsk.com
authors.forename: Jill E
authors.initials: JE
authors.lastname: Abell
authors.forename: Brent M
authors.initials: BM
authors.lastname: Egan
authors.forename: Peter W F
authors.initials: PW
authors.lastname: Wilson
authors.forename: Stuart
authors.initials: S
authors.lastname: Lipsitz
authors.forename: Robert F
authors.initials: RF
authors.lastname: Woolson
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Lackland
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000401:mortality*; D005260:Female; D006801:Humans; D008875:Middle Aged; D050177:Overweight / Q000208:ethnology; D016016:Proportional Hazards Models; D044465:White People; D016387:Women's Health