Being overweight or obese is a risk factor for myocardial infarction and ischemic heart disease regardless of whether individuals also have the cluster of cardiovascular risk factors known as metabolic syndrome, which includes hypertension, high cholesterol and hyperglycemia, according to a Danish study.
Being overweight or obese likely causes MI and IHD, but whether co-existing metabolic syndrome is necessary for the conditions to develop is unknown, according to background information in the study, which was published Nov. 11 on the website of JAMA Internal Medicine.
Børge G. Nordestgaard, MD, DMSc, and Mette Thomsen, MD, from Herlev Hospital, Copenhagen University Hospital, Denmark, investigated the associations by examining data from 71,527 participants in a general population study based in Copenhagen.
During nearly four years of follow-up, the researchers identified 634 cases of MI and 1,781 cases of IHD. Relative to people with normal weight, the hazards of MI were increased with overweight and obesity and were statistically equivalent whether or not patients had metabolic syndrome.
The researchers also found increasing cumulative incidences of MI and IHD among individuals both with and without metabolic syndrome from normal weight through overweight to obese individuals.
These findings suggest that overweight and obesity are risk factors for MI and IHD regardless of the presence or absence of metabolic syndrome and that metabolic syndrome is no more valuable than BMI [body mass index] in identifying individuals at risk, the authors concluded.
In a commentary, Chandra L. Jackson, PhD, MS, and Meir J. Stampfer, MD, DrPH, of the Harvard School of Public Health, Boston wrote: Besides questions related to how much added value there is to assessing MetS (beyond its component elements), the findings from this study have important implications and clearly corroborate the clinical and public health message that adiposity is not benign and that achieving and maintaining a healthy body weight is of paramount importance.
They added that the findings are important new evidence to counter the common belief in the scientific and lay communities that the adverse health effects of overweight are generally inconsequential as long as the individual is metabolically healthy.
In contrast, this study adds further evidence for the increased risks associated with overweight, even among those who might be considered metabolically healthy. These results also underscore the importance of focusing on weight-gain prevention due to the difficulty in achieving and maintaining weight loss to reverse being overweight or obese.
Study abstract: http://archinte.jamanetwork.com/article.aspx?articleid=1770522