Eight-year change in body mass index and subsequent risk of cardiovascular disease among healthy non-smoking men.
OBJECTIVE
To determine how change in BMI over 8 years is associated with risk of subsequent cardiovascular disease (CVD) among middle aged men.


METHODS
Prospective cohort study among 13,230 healthy men (aged 51.6+/-8.7 years) in the Physicians' Health Study. BMI was collected at baseline in 1982 and after 8 years, at which time follow-up began. Subsequent CVD events were collected and confirmed through March 31, 2005. Cox proportional hazards models evaluated BMI at 8 years and risk of CVD, 8-year change in BMI and risk of CVD, and whether change in BMI added prognostic information after the consideration of BMI at 8 years.


RESULTS
1308 major CVD events occurred over 13.5 years. A higher BMI at year 8 was associated with an increased risk of CVD. Compared to a stable BMI (+/-0.5 kg/m(2)), a 0.5-2.0 kg/m(2) increase had a multivariable-adjusted RR of 1.00 (0.86-1.16). A >/=2.0 kg/m(2) increase had a multivariable-adjusted RR of 1.39 (1.16-1.68), however further adjustment for BMI reduced the RR to 1.00 (0.81-1.23). A decrease in BMI had a multivariable RR of 1.23 (1.07-1.42) which was unaffected by adjustment for BMI at 8 years.


CONCLUSIONS
A higher BMI and a rising BMI were both associated with an increased risk of CVD, however an increasing BMI did not add prognostic information once current BMI was considered. In contrast, a declining BMI was associated with an increased risk of CVD independent of current BMI.
Bowman
Thomas S
TS
VA Boston Healthcare System -- Massachusetts Veterans Affairs Epidemiology, Research, and Information Center (MAVERIC), Boston, MA, USA. tsbowman@partners.org
Kurth
Tobias
T
Sesso
Howard D
HD
Manson
Joann E
JE
Gaziano
J Michael
JM
D000328:Adult; D001241:Aspirin / Q000008:administration & dosage; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D002423:Cause of Death; D015331:Cohort Studies; D004311:Double-Blind Method; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010820:Physicians; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D016019:Survival Analysis; D015431:Weight Loss; D019207:beta Carotene / Q000008:administration & dosage
D019207:beta Carotene; D001241:Aspirin