title: Relation of longitudinal changes in body mass index with atherosclerotic cardiovascular disease risk scores in middle-aged black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study.
abstract: We assessed whether longitudinal changes in body mass index (BMI) are positively associated with changes in 10-year American College of Cardiology/American Heart Association atherosclerotic cardiovascular disease (ASCVD) risk scores in middle-aged blacks compared to whites.
  
  
  
  Data were from 1691 participants enrolled in the Coronary Artery Risk Development in Young Adults Study aged 40 years or more in 2000-2001, who had follow-up examinations 5 and 10 years later.
  
  
  
  The prevalence of obesity increased from 32.3% in 2000-2001 (mean age: 42.8 years) to 41.7% in 2010-2011, higher in blacks than whites. The corresponding change in 10-year ASCVD risk was significantly higher for blacks (men: 4.5%-9.6%, women: 1.7%-5.0%) than whites (men: 2.4%-5.2%, women: 0.7%-1.6%). In 2010-2011, 57.5% of black men had ASCVD risk scores of 7.5% or more compared to white men (14.7%), black women (17.4%), and white women (1.6%). Although BMI trends were positively associated with 10-year change in ASCVD risk scores (0.07% per 1 kg/m(2) increase), it explained very little variance in risk score trends in all race-sex groups.
  
  
  
  In middle-aged adults, longitudinal changes in BMI had little independent influence on changes in 10-year ASCVD risk scores as its effect may be largely mediated through ASCVD risk factors already accounted for in the risk score.
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis. Electronic address: dappiah@umn.edu.
authors.forename: Duke
authors.initials: D
authors.lastname: Appiah
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schreiner
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham.
authors.forename: Raegan W
authors.initials: RW
authors.lastname: Durant
authors.affiliation: Quantitative Health Sciences, University of Massachusetts, Worcester.
authors.forename: Catarina I
authors.initials: CI
authors.lastname: Kiefe
authors.affiliation: Division of Cardiovascular Sciences, NIH/NHLBI, Bethesda, MD.
authors.forename: Catherine
authors.initials: C
authors.lastname: Loria
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham.
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.affiliation: Department of Biostatistics, Florida International University, Miami.
authors.forename: O Dale
authors.initials: OD
authors.lastname: Williams
authors.affiliation: Quantitative Health Sciences, University of Massachusetts, Worcester.
authors.forename: Sharina D
authors.initials: SD
authors.lastname: Person
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sidney
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D001499:Bayes Theorem; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
keywords: Cardiovascular disease; Obesity; Risk prediction