title: Prognostic value of obesity on both overall mortality and cardiovascular disease in the general population.
abstract: BACKGROUND
  Obesity represents an important health problem and its association with cardiovascular risk factors is well-known. The aim of this work was to assess the correlation between obesity and mortality (both, all-cause mortality and the combined variable of all-cause mortality plus the appearance of a non-fatal first cardiovascular event) in a general population sample from the south-east of Spain.
  
  
  METHODS
  This prospective cohort study used stratified and randomized two-stage sampling. Obesity [body mass index (BMI) ≥ 30 kg/m(2)] as a predictive variable of mortality and cardiovascular events was assessed after controlling for age, sex, cardiovascular disease history, high blood pressure, diabetes mellitus, hypercholesterolemia, high-density lipoprotein/triglycerides ratio, total cholesterol and smoking with the Cox regression model.
  
  
  RESULTS
  The mean follow-up time of the 1,248 participants was 10.6 years. The incidence of all-cause mortality during this period was 97 deaths for every 10,000 person/years (95% CI: 80-113) and the incidence of all-cause mortality+cardiovascular morbidity was 143 cases for every 10,000 person/years (95% CI: 124-163). A BMI ≥ 35 kg/m(2) yielded a hazard ratio for all-cause mortality of 1.94 (95% CI: 1.11-3.42) in comparison to non-obese subjects (BMI <30 kg/m(2)). For the combination of cardiovascular morbidity plus all-cause mortality, a BMI ≥ 35 kg/m(2) had a hazard ratio of 1.84 (95% CI: 1.15-2.93) compared to non-obese subjects.
  
  
  CONCLUSIONS
  A BMI ≥ 35 kg/m(2) is an important predictor of both overall mortality and of the combination of cardiovascular morbidity plus all-cause mortality.
authors.affiliation: Casas Ibáñez Primary Health Care Centre, Health Service of Castilla la Mancha, Albacete, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Ponce-Garcia
authors.affiliation: Zona IV Primary Health Care Centre, Health Service of Castilla la Mancha, Albacete, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Simarro-Rueda
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain; Cátedra de Riesgo Cardiovascular, San Antonio Catholic University, Murcia, Spain.
authors.forename: Julio Antonio
authors.initials: JA
authors.lastname: Carbayo-Herencia
authors.affiliation: Casas Ibáñez Primary Health Care Centre, Health Service of Castilla la Mancha, Albacete, Spain; Cátedra de Riesgo Cardiovascular, San Antonio Catholic University, Murcia, Spain.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Divisón-Garrote
authors.affiliation: Zona III Primary Health Care Centre, Health Service of Castilla la Mancha, Albacete, Spain.
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Artigao-Ródenas
authors.affiliation: Endocrinology and Nutrition Service, General Hospital, Albacete, Spain; Castilla La Mancha School of Medicine, Albacete, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Botella-Romero
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain; Research Unit, Elda General Hospital, Elda, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Palazón-Bru
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain.
authors.forename: Damian Robert James
authors.initials: DR
authors.lastname: Martínez-St John
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain; Research Unit, Elda General Hospital, Elda, Spain.
authors.forename: Vicente Francisco
authors.initials: VF
authors.lastname: Gil-Guillén
mesh_terms: D002318:Cardiovascular Diseases / Q000150:complications* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000145:classification / Q000150:complications* / Q000401:mortality*; D011379:Prognosis; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome