title: Association Between Body Mass Index and Age of Presentation With Symptomatic Coronary Artery Disease.
abstract: BACKGROUND
  Obesity is increasingly recognized as an important risk factor for coronary artery disease (CAD).
  
  
  OBJECTIVE
  Patients with increased body mass index (BMI) present at a younger age with symptomatic CAD.
  
  
  METHODS
  We analyzed data on 2137 consecutive patients admitted for treatment of CAD proven on angiography from 2010 to 2013, excluding those with prior coronary intervention or bypass surgery.
  
  
  RESULTS
  Mean age was 64.1 ± 12.4 years; 75% were male; 43.6% were overweight (BMI 25-29.9 kg/m2) and 31.6% were obese (BMI ≥30 kg/m2). Patients with BMI ≥25 kg/m2compared with <25 kg/m2were more likely to have diabetes (24.5% vs 13.6%), hypertension (56.2% vs 45.5%), and hyperlipidemia (42.4% vs 31.6%; P < 0.0001 for all). On multivariate analysis adjusted for sex and cardiovascular risk factors, patients in higher BMI categories had lower mean age in a linear and stepwise fashion compared with those with normal BMI (P < 0.0001). For example, compared with patients with normal BMI, those with BMI of 35 to 39.9 kg/m2were on average 9.2 years younger (P < 0.0001). Multivariate analysis examining the interaction between sex and BMI produced similar results for effect of BMI on age of presentation (P = 0.97 for interaction).
  
  
  CONCLUSIONS
  After multivariate adjustment, patients with increased BMI presented at an earlier age with symptomatic CAD compared with patients with normal BMI. Primary prevention efforts in those with increased BMI to reduce risk-factor burden, including evidence-based treatments for weight reduction, promise to reduce risk or delay onset of CAD.
authors.affiliation: Department of Cardiology, The Canberra Hospital, Canberra, Australia.
authors.forename: Syed M
authors.initials: SM
authors.lastname: Atique
authors.affiliation: College of Medicine, Biology and Environment, Australian National University, Canberra, Australia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Shadbolt
authors.affiliation: Department of Cardiology, The Canberra Hospital, Canberra, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Marley
authors.affiliation: Department of Cardiology, The Canberra Hospital, Canberra, Australia.|College of Medicine, Biology and Environment, Australian National University, Canberra, Australia.
authors.forename: Ahmad
authors.identifier: http://orcid.org/0000-0001-9888-7663
authors.initials: A
authors.lastname: Farshid
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D020958:Australian Capital Territory; D015992:Body Mass Index; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
keywords: Body mass index; Cardiac; Coronary artery disease; Obesity; Preventive cardiology; Risk factors; rehabilitation