title: Long- and short-term weight change and incident coronary heart disease and ischemic stroke: the Atherosclerosis Risk in Communities Study.
abstract: Weight gain increases the prevalence of obesity, a risk factor for cardiovascular disease. Nevertheless, unintentional weight loss can be a harbinger of health problems. The Atherosclerosis Risk in Communities Study (1987-2009) included 15,792 US adults aged 45-64 years at baseline and was used to compare associations of long-term (30 years) and short-term (3 years) weight change with the risks of coronary heart disease (CHD) and ischemic stroke. Age-, gender-, and race-standardized incidence rates were 4.9 (95% confidence interval (CI): 4.6, 5.2) per 1,000 person-years for CHD and 2.5 (95% CI: 2.3, 2.8) per 1,000 person-years for stroke. After controlling for baseline body mass index and other covariates, long-term weight gain (since age 25 years) of more than 2.7% was associated with elevated CHD risk, and any long-term weight gain was associated with increased stroke risk. Among middle-aged adults, short-term (3-year) weight loss of more than 3% was associated with elevated immediate CHD risk (hazard ratio = 1.46, 95% CI: 1.18, 1.81) and stroke risk (hazard ratio = 1.45, 95% CI: 1.10, 1.92). Risk tended to be larger in adults whose weight loss did not occur through dieting. Avoidance of weight gain between early and middle adulthood can reduce risks of CHD and stroke, but short-term, unintentional weight loss in middle adulthood may be an indicator of immediate elevated risk that has not previously been well recognized.
authors: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 2207 McGavran-Greenberg Hall, CB 7461, Chapel Hill, NC 27599, USA. june_stevens@unc.edu
authors: June
authors: J
authors: Stevens
authors: Eva
authors: E
authors: Erber
authors: Kimberly P
authors: KP
authors: Truesdale
authors: Chin-Hua
authors: CH
authors: Wang
authors: Jianwen
authors: J
authors: Cai
mesh_terms: D000328:Adult; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D016016:Proportional Hazards Models; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D015430:Weight Gain; D015431:Weight Loss
keywords: body mass index; body weight changes; coronary heart disease; ischemic stroke
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