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Higher BMI worsens CV health in young patients
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Patients with higher BMI, including young patients, had an increased risk for worse CV health, particularly increased BP and left ventricular mass index, according to an analysis published in Circulation.
“Thickening of vessel walls is widely considered to be the first sign of atherosclerosis, a disease in which fatty plaques build up within the arteries and lead to heart disease,” Kaitlin H. Wade, BSc, PhD, research associate at the Medical Research Council Integrative Epidemiology Unit at University of Bristol Medical School in England, said in a press release. “However, our findings suggest that higher BMI cause changes in the heart structure of the young that may precede changes in blood vessels.”
Researchers analyzed data from the ALSPAC study of patients who were born between April 1991 and December 1992. Patients were followed up regularly with clinical measures and questionnaires to collect lifestyle, behavioral and biological data. Data in this analysis included patients aged 17 years (n = 1,420-3,108 for different CV outcomes; 48% girls) and those aged 21 years (n = 386-418 for different outcomes; 66% women).
Mendelian randomization was used on data for patients aged 17 years, whereas subsample recall-by-genotype analyses were performed on the data of patients aged 21 years. The CV phenotypes used in the Mendelian randomization analysis included heart rate, BP, carotid intima-media thickness, carotid-femoral pulse wave velocity and LV mass index. In the recall-by-genotype group, data that were assessed included measurements of detailed phenotypes such as stroke volume, LV mass index, systemic vascular resistance, cardiac output and total arterial compliance.
Patients with a higher BMI had LV mass index in both the Mendelian randomization (difference per 1 kg/m2 = 1.07 g/m2.7; 95% CI, 0.62-1.52) and recall-by-genotype groups (difference per 3.58 kg/m2 = 1.65 g/m2.7; 95% CI, 0.83-2.47). These patients also had higher systolic (difference = 0.79 mm Hg; 95% CI, 0.3-1.28) and diastolic BP (difference = 0.29 mm Hg; 95% CI, 0.0002-0.59).
Results of the recall-by-genotype analysis found a link between higher BMI and increased cardiac output (difference per 3.58 kg/m2 = 0.11 L/min-1/m-1.83; 95% CI, 0.03-0.19) and stroke volume (difference per 3.58 kg/m2 = 1.49 mL/m2.04; 95% CI, 0.62-2.35). A causal role was not seen for total arterial compliance or systemic vascular resistance.
Both analyses did not support a causal role of higher BMI on heart rate.
“These findings support efforts to reduce BMI from a young age, with the aim of attenuating the development of precursors of long-term adverse cardiovascular outcomes,” Wade and colleagues wrote. “Such efforts may help prevent the development of additional cardiac and peripheral vascular damage not yet evident at this early stage of life.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
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