title: Cardiovascular disease risk by assigned treatment using the 2013 and 1998 obesity guidelines.
abstract: The 1998 and the 2013 guidelines on management of overweight and obesity in adults provided algorithms for identification of patients to be treated with weight loss. To date, the cardiovascular disease (CVD) risk in the groups recommended or not recommended for weight loss treatment has not been estimated and compared.
  
  
  
  Baseline data for the Atherosclerosis Risk in Communities study were collected between 1987 and 1989 from adults aged 45 to 64 years. Black and White men and women free of CVD were followed over 22.8 years (median), and 2,907 incident CVD events were recorded.
  
  
  
  The hazard ratios adjusted for demographic variables in adults not recommended for treatment versus adults recommended for treatment were 0.54 (95% CI: 0.50-0.59) for the 1998 algorithm and 0.63 (95% CI: 0.58-0.69) for the 2013 algorithm, respectively. No gender or race differences were detected when the 2013 algorithm was applied, but using the 1998 algorithm, CVD risk between the groups recommended or not recommended for treatment was more pronounced in Black women than in Black men.
  
  
  
  The 2013 algorithm performed similarly in Black and White men and women but did not improve upon the 1998 algorithm in terms of discriminating risk of CVD.
authors.affiliation: Department of Nutrition, University of North Carolina at Chapel Hill, North Carolina, USA.|Department of Epidemiology, University of North Carolina at Chapel Hill, North Carolina, USA.
authors.forename: June
authors.initials: J
authors.lastname: Stevens
authors.affiliation: Department of Nutrition, University of North Carolina at Chapel Hill, North Carolina, USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Erber-Oakkar
authors.affiliation: Department of Nutrition, University of North Carolina at Chapel Hill, North Carolina, USA.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Cui
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, North Carolina, USA.
authors.forename: Jianwen
authors.initials: J
authors.lastname: Cai
authors.affiliation: Sections of Cardiovascular Research, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
authors.affiliation: Department of Public Health and Primary Care, University of Cambridge, UK.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Di Angelantonio
authors.affiliation: Department of Public Health and Primary Care, University of Cambridge, UK.
authors.forename: David
authors.initials: D
authors.lastname: Wormser
mesh_terms: D000465:Algorithms; D044383:Black People / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000628:therapy; D017410:Practice Guidelines as Topic; D016016:Proportional Hazards Models; D018570:Risk Assessment / Q000592:standards*; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data