Obesity in young adulthood linked to adverse heart structure, function later in life
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Key takeaways:
- People with obesity in young or middle adulthood have a greater chance of having adverse heart structure and function in their 60s.
- Maintaining a healthy weight is important even in early adulthood.
People with excess adiposity in young adulthood were more likely to have adverse cardiac structure and function later in life compared with people without it, researchers reported in the European Heart Journal.
“We know that being overweight is associated with poorer heart health, but we know little about the long-term relationship between being overweight over the adult life course and subsequent heart health,” Alun Hughes, MBBS, PhD, professor of cardiovascular physiology and pharmacology at University College London, said in a press release. “We wanted to look at whether being overweight at earlier stages of adult life showed lasting associations with poorer heart health irrespective of people’s weight in later life.”
Hughes and colleagues analyzed data from 1,690 participants from the National Survey of Health and Development birth cohort, all of whom were born in the U.K. in March 1946. All participants underwent obesity measurements (BMI and waist-to-hip ratio) at various points during adulthood, and echocardiography at age 60 to 64 years to determine the relationship between obesity at various time points and cardiac structure — left ventricular mass, relative wall thickness, LV internal diameter in diastole — and cardiac function — E/e’, e’ and left atrial volume indexed to surface area, ejection fraction, S’ and myocardial contraction function — at the time of echocardiography.
BMI and cardiac structure, function
Elevated BMI at any time point was associated with greater LV mass and LV internal diameter in diastole, independent of confounders, whereas elevated BMI at age 43 years was associated with greater relative wall thickness but not when BMI at age 60 to 64 years was accounted for, the researchers wrote.
Elevated BMI at 26, 36 and 53 years, and at 20 years onward, was associated with lower EF and myocardial contraction function, but not when BMI at age 60 to 64 years was accounted for, Hughes and colleagues wrote.
Elevated BMI from 20 years onward was associated with poor E/e’, e’ and left atrial volume indexed to surface area, even after adjustment for confounders, according to the researchers.
The relationship between elevated waist-to-hip ratio and cardiac structure and function was similar to that between elevated BMI and cardiac structure and function, but only from age 43 years onward, the researchers wrote.
As an example, at age 43 years, someone with BMI of an additional 5 kg/m2 had a 15% increase in LV mass.
“This suggests that weight gain, even at a young age, leads to heart damage over and above the effects of being overweight in later life,” Hughes said in the release. “Maintaining a healthy weight is likely to be important for people even in early adulthood, and if we want to improve heart health in the long term, we need to prevent weight gain in people of all ages. This means developing policies that will reduce the current epidemic of obesity.”
‘Compelling evidence’
In a related editorial, Leonardo Roever, MHS, PhD, MBA (Data Science), CEO of the Brazilian Evidence-Based Health Network in Uberlândia, Brazil, and colleagues wrote that “it is evident that this observational report provides compelling evidence in support of our ongoing fight against overweight and obesity as crucial cardiovascular risk factors, irrespective of patient age and degree of excess weight, supporting proactive preventive interventions against the ongoing obesity epidemic, including the focus on younger individuals as well as those who are more mature.”
References:
- Roever L, et al. Eur Heart J. 2024;doi:10.1093/eurheartj/ehae443.
- Weight gain in young and middle-aged adults is linked to poor heart health in older age. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Weight-gain-in-young-and-middle-aged-adults-is-linked-to-poor-heart-health-in-older-age. Published July 16, 2024. Accessed July 17, 2024.
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