Elevated BMI may not increase risk of death among men with heart attack or stroke

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BMI, or body mass index, is considered an indicator of both mortality and heart attack risk among middle-aged and older men free of major diseases. However, the impact of BMI on mortality in men who have already had a heart attack or stroke has not been clearly established.

In the largest analysis to date, researchers from Brigham and Women’s Hospital (BWH) report that men with an elevated BMI – 28.0 kg/m 2 or greater – may not have an increased risk of death as compared to men with a lower BMI.

“This study does not eliminate a small amount of risk for being overweight or obese,” said author Howard D. Sesso, ScD, MPH, of BWH. “However, it does tell physicians that BMI may not have a prominent role in predicting the future risk of death among men who may have already experienced the cardiovascular complications of obesity by having a heart attack or stroke.”

In this study, researchers examined 5,010 middle-aged and older men from the Physicians’ Health Study with approximately five years of follow-up data. Those analyzed included men who had a self-reported history of heart attack or stroke, while excluding those with cancer. Four BMI categories were used that ranged from less than 22.0 kg/m 2 (normal weight men) to 28.0 kg/m 2 or greater (which includes both overweight and obese men). Researchers found that men who already had a heart attack or stroke with a BMI of 28 kg/m 2 or greater did not have a significantly greater risk of overall death or death from cardiovascular disease.

According to Sesso, “Although it is a matter of debate as to why BMI may be less important in the secondary prevention of cardiovascular disease, we know that in primary prevention having a progressively higher BMI results in large increases in the risk of cardiovascular disease, diabetes mellitus and other disorders. For those men who have already suffered from a heart attack or stroke, researchers must identify stronger risk factors than body mass index for mortality to ensure that an optimal secondary prevention strategy is used.”



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