Healthy obesity harmful to cardiovascular health
The risk of coronary heart disease (CHD), cerebrovascular disease and heart failure is greater among metabolically healthy obese than normal weight metabolically healthy individuals, suggests a recent study. Additionally, even those who are normal weight can have metabolic abnormalities and similar risks for cardiovascular disease (CVD) events.
In this study that investigated the associations among metabolically healthy obese individuals and four different presentations of incident CVD in a contemporary population, researchers used linked electronic health records (1995 to 2015) in The Health Improvement Network to gather a cohort of 3.5 million individuals, aged ≥18 years and initially free of CVD.
Participants were divided according to “body size phenotypes” defined by body mass index (BMI) categories: underweight (BMI, <18.5 kg/m2), normal weight (BMI, 18.5 to <25 kg/m2), overweight (BMI, 25 to <30 kg/m2) and obesity (BMI, >30 kg/m2). Researchers also considered three metabolic abnormalities: diabetes, hypertension and hyperlipidaemia.
The primary endpoints were the first record of one of four CV presentations (CHD, cerebrovascular disease, heart failure and peripheral vascular disease).
During a mean 5.4 years of follow-up, obese individuals with no metabolic abnormalities had greater risk of CHD (multivariate-adjusted hazard ratio [HR], 1.49; 95 percent CI, 1.45 to 1.54), cerebrovascular disease (HR, 1.07; 1.04 to 1.11) and heart failure (HR, 1.96; 1.86 to 2.06) compared with normal weight individuals with no metabolic abnormalities.
An increasing number of metabolic abnormalities also resulted in an increased risk of CHD, cerebrovascular disease and heart failure in normal weight, overweight and obese individuals.
"So-called 'metabolically healthy' obesity is clearly not a harmless condition and the term should no longer be used in order to prevent misleading individuals that obesity can be healthy," said lead author Dr Rishi Caleyachetty of the Institute of Applied Health Research University of Birmingham.