title: Excess body mass index- and waist circumference-years and incident cardiovascular disease: the CARDIA study.
abstract: OBJECTIVE
  To determine the influence of the total cumulative exposure to excess overall and abdominal adiposity on the incidence of cardiovascular disease (CVD).
  
  
  METHODS
  Prospective study of 4,061 white and black adults without CVD at baseline in 1985-1986 (age 18-30 years) from the multicenter, community-based CARDIA study. Time-varying excess body mass index (BMI)- and waist circumference (WC)-years were calculated as products of the degree and duration of excess overall (BMI ≥ 25 kg/m(2)) and abdominal adiposity [WC >94 cm (men) and >80 cm (women)], respectively, collected at up to eight examinations.
  
  
  RESULTS
  During a median of 24.8 years, there were 125 incident CVD, 62 coronary heart disease (CHD), and 33 heart failure (HF) events. Adjusted hazard ratios for CVD, CHD, and HF for each additional 50 excess BMI-years were 1.20 (1.08, 1.34), 1.25 (1.07, 1.46), and 1.45 (1.23, 1.72), respectively. For each 50 excess WC-years, these hazard ratios were 1.10 (1.04, 1.18), 1.13 (1.03, 1.24), and 1.22 (1.11, 1.34), respectively. Akaike information criterion values were lowest in models containing time-varying excess BMI- or WC-years compared to those including time-varying BMI or WC only.
  
  
  CONCLUSIONS
  Excess BMI- and WC-years are predictors of the risk of CVD and may provide a better indicator of the cumulative exposure to excess adiposity than BMI or WC only.
authors.affiliation: Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA.
authors.forename: Jared P
authors.initials: JP
authors.lastname: Reis
authors.forename: Norrina
authors.initials: N
authors.lastname: Allen
authors.forename: Erica P
authors.initials: EP
authors.lastname: Gunderson
authors.forename: Joyce M
authors.initials: JM
authors.lastname: Lee
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Loria
authors.forename: Tiffany M
authors.initials: TM
authors.lastname: Powell-Wiley
authors.forename: Jamal S
authors.initials: JS
authors.lastname: Rana
authors.forename: Stephen
authors.initials: S
authors.lastname: Sidney
authors.forename: Gina
authors.initials: G
authors.lastname: Wei
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yano
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000150:complications; D003327:Coronary Disease / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control; D056128:Obesity, Abdominal / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D055105:Waist Circumference; D044465:White People / Q000706:statistics & numerical data