Authors
Schulte H. Cullen P. Assmann G.
Institution
Institut fur Arterioskleroseforschung, an der Universitat Munster, Germany.
Title
Obesity, mortality and
cardiovascular disease in the Munster Heart Study (PROCAM).
Source
Atherosclerosis. 144(1):199-209, 1999 May.
Abstract
In the Munster Heart Study (PROCAM), 16,288 men aged 40.6 +/- 11.3 years
(mean +/- S.D.) and 7328 women aged 36.0 +/- 12.3 years were enrolled between
1979 and 1991. Mean body mass indices (BMIs) were 25.6 +/- 3.3 and 23.8 +/-
4.1 kg/m2 in men and women, respectively. There was a graded and continuous
positive interaction in both men and women between BMI, age and serum total
cholesterol, low density lipoprotein (LDL) cholesterol, and blood pressure
(both systolic and diastolic). High density lipoprotein (HDL) cholesterol
tended to increase with age, but decreased in graded fashion with increases
in BMI in both sexes. Triglyceride increased with BMI in both sexes and with
age in women, but decreased in the older age groups of overweight and obese
men. Though fasting blood glucose increased with age and BMI in both sexes,
the increase was more marked in women. Among the 10,856 men aged 36-65 years
at study entry, 313 deaths occurred within a follow-up period of 7.1 +/- 2.4
years. Among these men, increased mortality was seen at high
BMIs in both smokers and non-smokers and was caused by coronary heart disease
(CHD). Increased mortality at low BMI was seen in smokers
but not in non-smokers and was due to an increase in cancer deaths. The
BMI-associated increase in CHD death was completely accounted for by the
factors contained in the Munster Heart Study (PROCAM) risk algorithm,
indicating that the effect of overweight and obesity on CHD is mediated via
other risk factors.