Severe obesity, heart disease, and death among white, african american, and hispanic postmenopausal women

Kathleen M. McTigue, Yue Fang Chang, Charles Eaton, Lorena Garcia, Karen Johnson, Cora E. Lewis, Simin Liu, Rachel H. Mackey, Jennifer Robinson, Milagros C. Rosal, Linda Snetselaar, Alice Valoski, Lewis H. Kuller

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Abstract

Objective To compare mortality, nonfatal coronary heart disease (CHD), and congestive heart failure (CHF) risk across BMI categories in white, African American, and Hispanic women, with a focus on severe obesity (BMI ≥ 40), and examine heterogeneity in weight-related CHD risk. Methods Among 156,775 Women's Health Initiative observational study and clinical trial participants (September 1993-12 September 2005), multivariable Cox models estimated relative risk for mortality, CHD, and CHF. CHD incidence was calculated by anthropometry, race, and cardiovascular risk factors (CVRF). Results Mortality, nonfatal CHD, and CHF incidence generally rose with BMI category. For severe obesity versus normal BMI, hazard ratios (HRs, 95% confidence interval) for mortality were 1.97 (1.77-2.20) in white, 1.55 (1.20-2.00) in African American, and 2.59 (1.55-4.31) in Hispanic women; for CHD, HRs were 2.05 (1.80-2.35), 2.24 (1.57-3.19), and 2.95 (1.60-5.41) respectively; for CHF, HRs were 5.01 (4.33-5.80), 3.60 (2.30-5.62), and 6.05 (2.49-14.69). CVRF variation resulted in substantial variation in CHD rates across BMI categories, even in severe obesity. CHD incidence was similar by race/ethnicity when differences in BMI or CVRF were accounted for. Conclusions Severe obesity increases mortality, nonfatal CHD, and CHF risk in women of diverse race/ethnicity. CVRF heterogeneity contributes to variation in CHD incidence even in severe obesity.

Original languageEnglish (US)
Pages (from-to)801-810
Number of pages10
JournalObesity
Volume22
Issue number3
DOIs
StatePublished - Jan 1 2014

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Morbid Obesity
Hispanic Americans
African Americans
Coronary Disease
Heart Diseases
Heart Failure
Mortality
Incidence
Anthropometry
Women's Health
Proportional Hazards Models
Observational Studies
Heart Rate
Clinical Trials
Confidence Intervals
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics

Cite this

McTigue, K. M., Chang, Y. F., Eaton, C., Garcia, L., Johnson, K., Lewis, C. E., ... Kuller, L. H. (2014). Severe obesity, heart disease, and death among white, african american, and hispanic postmenopausal women. Obesity, 22(3), 801-810. https://doi.org/10.1002/oby.20224

Severe obesity, heart disease, and death among white, african american, and hispanic postmenopausal women. / McTigue, Kathleen M.; Chang, Yue Fang; Eaton, Charles; Garcia, Lorena; Johnson, Karen; Lewis, Cora E.; Liu, Simin; Mackey, Rachel H.; Robinson, Jennifer; Rosal, Milagros C.; Snetselaar, Linda; Valoski, Alice; Kuller, Lewis H.

In: Obesity, Vol. 22, No. 3, 01.01.2014, p. 801-810.

Research output: Contribution to journalArticle

McTigue, KM, Chang, YF, Eaton, C, Garcia, L, Johnson, K, Lewis, CE, Liu, S, Mackey, RH, Robinson, J, Rosal, MC, Snetselaar, L, Valoski, A & Kuller, LH 2014, 'Severe obesity, heart disease, and death among white, african american, and hispanic postmenopausal women', Obesity, vol. 22, no. 3, pp. 801-810. https://doi.org/10.1002/oby.20224
McTigue, Kathleen M. ; Chang, Yue Fang ; Eaton, Charles ; Garcia, Lorena ; Johnson, Karen ; Lewis, Cora E. ; Liu, Simin ; Mackey, Rachel H. ; Robinson, Jennifer ; Rosal, Milagros C. ; Snetselaar, Linda ; Valoski, Alice ; Kuller, Lewis H. / Severe obesity, heart disease, and death among white, african american, and hispanic postmenopausal women. In: Obesity. 2014 ; Vol. 22, No. 3. pp. 801-810.
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abstract = "Objective To compare mortality, nonfatal coronary heart disease (CHD), and congestive heart failure (CHF) risk across BMI categories in white, African American, and Hispanic women, with a focus on severe obesity (BMI ≥ 40), and examine heterogeneity in weight-related CHD risk. Methods Among 156,775 Women's Health Initiative observational study and clinical trial participants (September 1993-12 September 2005), multivariable Cox models estimated relative risk for mortality, CHD, and CHF. CHD incidence was calculated by anthropometry, race, and cardiovascular risk factors (CVRF). Results Mortality, nonfatal CHD, and CHF incidence generally rose with BMI category. For severe obesity versus normal BMI, hazard ratios (HRs, 95{\%} confidence interval) for mortality were 1.97 (1.77-2.20) in white, 1.55 (1.20-2.00) in African American, and 2.59 (1.55-4.31) in Hispanic women; for CHD, HRs were 2.05 (1.80-2.35), 2.24 (1.57-3.19), and 2.95 (1.60-5.41) respectively; for CHF, HRs were 5.01 (4.33-5.80), 3.60 (2.30-5.62), and 6.05 (2.49-14.69). CVRF variation resulted in substantial variation in CHD rates across BMI categories, even in severe obesity. CHD incidence was similar by race/ethnicity when differences in BMI or CVRF were accounted for. Conclusions Severe obesity increases mortality, nonfatal CHD, and CHF risk in women of diverse race/ethnicity. CVRF heterogeneity contributes to variation in CHD incidence even in severe obesity.",
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AU - McTigue, Kathleen M.

AU - Chang, Yue Fang

AU - Eaton, Charles

AU - Garcia, Lorena

AU - Johnson, Karen

AU - Lewis, Cora E.

AU - Liu, Simin

AU - Mackey, Rachel H.

AU - Robinson, Jennifer

AU - Rosal, Milagros C.

AU - Snetselaar, Linda

AU - Valoski, Alice

AU - Kuller, Lewis H.

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N2 - Objective To compare mortality, nonfatal coronary heart disease (CHD), and congestive heart failure (CHF) risk across BMI categories in white, African American, and Hispanic women, with a focus on severe obesity (BMI ≥ 40), and examine heterogeneity in weight-related CHD risk. Methods Among 156,775 Women's Health Initiative observational study and clinical trial participants (September 1993-12 September 2005), multivariable Cox models estimated relative risk for mortality, CHD, and CHF. CHD incidence was calculated by anthropometry, race, and cardiovascular risk factors (CVRF). Results Mortality, nonfatal CHD, and CHF incidence generally rose with BMI category. For severe obesity versus normal BMI, hazard ratios (HRs, 95% confidence interval) for mortality were 1.97 (1.77-2.20) in white, 1.55 (1.20-2.00) in African American, and 2.59 (1.55-4.31) in Hispanic women; for CHD, HRs were 2.05 (1.80-2.35), 2.24 (1.57-3.19), and 2.95 (1.60-5.41) respectively; for CHF, HRs were 5.01 (4.33-5.80), 3.60 (2.30-5.62), and 6.05 (2.49-14.69). CVRF variation resulted in substantial variation in CHD rates across BMI categories, even in severe obesity. CHD incidence was similar by race/ethnicity when differences in BMI or CVRF were accounted for. Conclusions Severe obesity increases mortality, nonfatal CHD, and CHF risk in women of diverse race/ethnicity. CVRF heterogeneity contributes to variation in CHD incidence even in severe obesity.

AB - Objective To compare mortality, nonfatal coronary heart disease (CHD), and congestive heart failure (CHF) risk across BMI categories in white, African American, and Hispanic women, with a focus on severe obesity (BMI ≥ 40), and examine heterogeneity in weight-related CHD risk. Methods Among 156,775 Women's Health Initiative observational study and clinical trial participants (September 1993-12 September 2005), multivariable Cox models estimated relative risk for mortality, CHD, and CHF. CHD incidence was calculated by anthropometry, race, and cardiovascular risk factors (CVRF). Results Mortality, nonfatal CHD, and CHF incidence generally rose with BMI category. For severe obesity versus normal BMI, hazard ratios (HRs, 95% confidence interval) for mortality were 1.97 (1.77-2.20) in white, 1.55 (1.20-2.00) in African American, and 2.59 (1.55-4.31) in Hispanic women; for CHD, HRs were 2.05 (1.80-2.35), 2.24 (1.57-3.19), and 2.95 (1.60-5.41) respectively; for CHF, HRs were 5.01 (4.33-5.80), 3.60 (2.30-5.62), and 6.05 (2.49-14.69). CVRF variation resulted in substantial variation in CHD rates across BMI categories, even in severe obesity. CHD incidence was similar by race/ethnicity when differences in BMI or CVRF were accounted for. Conclusions Severe obesity increases mortality, nonfatal CHD, and CHF risk in women of diverse race/ethnicity. CVRF heterogeneity contributes to variation in CHD incidence even in severe obesity.

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