Abstract 15669: Combined Association of Midlife Obesity and Fitness With Longterm Risk of Heart Failure - The Cooper Center Longitudinal Study
Background: Both obesity and cardiorespiratory fitness are associated with an increased risk of heart failure (HF). However, the association of measures of obesity and fitness on subsequent HF is not well established. We therefore sought to determine the association between different obesity measures and subsequent HF risk, independent of fitness.
Methods: Linking individual participant data from the Cooper Center Longitudinal Study with Medicare claims files, we included 20,489 participants (mean age 49.4±8.8 years; 22% female) who survived to receive Medicare coverage from 1999-2009. Fitness was estimated in metabolic equivalents (METS) according to Balke treadmill time. Associations between BMI and fitness with HF hospitalization after age 65 were assessed by applying a proportional hazards model to the multivariate time data. Further analysis was performed on a subgroup of participants (N=7,589) with other anthropometric measures of obesity including waist-hip ratio (WHR), waist circumference (WC), and % body fat, to evaluate the association between these variables and subsequent HF.
Results: After 25.5 years of follow-up, we observed 1051 HF events. BMI was associated with HF hospitalization after adjusting for multiple HF risk factors but was attenuated after adjusting for fitness (see Table). We also observed a strong inverse association between fitness and HF. In contrast, we observed no association between other measures of obesity and long-term risk for HF: WHR (HR, 95% confidence interval): 1.00, 0.99-1.00, p=0.26; WC: 0.98, 0.95-1.02, p=0.25; % body fat: 1.00, 0.94-1.05, p=0.88.
Conclusion: Higher BMI was the only obesity measure in middle age associated with a long-term risk for HF. This association was substantially attenuated after adjustment for fitness.
- © 2013 by American Heart Association, Inc.