Abstract 45: Prior Weight History Provides Prognostic Information Beyond Current Weight Regarding HF Risk
Background: While obesity is an established risk factor for heart failure (HF), there are limited prospective analyses examining the relationship of weight history or trajectories of weight change with incident HF.
Hypothesis: We hypothesized that prior overweight and obesity, and increasing weight over time, would be associated with an increased risk of incident HF.
Methods: We performed a prospective analysis of 9,710 ARIC Visit 4 (1996-98) participants with available body-mass index (BMI) measurements at Visit 1 (1987-89) and Visit 4, excluding those with CVD at Visit 4 or BMI < 18.5. BMI (kg/m2) at Visits 1 and 4 was categorized as normal weight (18.5-24.9), overweight (25-29.9) or obese (≥30). We additionally categorized BMI based on self-reported weight at age 25 (reported at Visit 1; N=9,122). The primary outcome was incident HF occurring after Visit 4. Cox regression with cross tabulations of BMI categories at Visit 4 and at each of the earlier time points (Visit 1 or age 25, in separate models) was performed to assess the association of different weight history patterns with incident HF.
Results: Over the 9 years from Visit 1 to 4, 72% remained in a stable BMI category, 23% increased to a higher BMI category and 5% decreased. Less weight stability was seen from age 25 to Visit 4 (33% stable, 65% increased, 2% decreased). Higher HF risk was seen with increases in BMI category from Visit 1 to 4 (HR 1.26 [1.07-1.49]) and from age 25 to Visit 4 (HR 1.44 [1.24-1.67]) relative to stable weight, with non-significant risk if BMI category decreased. In analyses assessing combinations of BMI categories at Visit 4 and at an earlier time point (Table), higher BMI category at an earlier time point was associated with greater risk within each Visit 4 BMI category. Individuals who remained obese at both time points had the highest risk of incident HF.
Conclusion: Prior elevated weight and increasing weight over time are associated with an increased risk of HF. Weight history may be more informative than single anthropometric measurements for assessing HF risk.
Author Disclosures: C.E. Ndumele: None. L. Cobb: None. M. Lazo: None. N. Bello: None. A. Shah: None. V. Nambi: None. R.S. Blumenthal: None. G. Gerstenblith: None. S.D. Solomon: None. C.M. Ballantyne: None. E. Selvin: None. J. Coresh: None.
- © 2015 by American Heart Association, Inc.