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| - Cohort study of effect of being overweight and change in weight on risk of coronary heart disease in old age
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| - Abstract. Objective: To evaluate risk of late life coronary heart disease associated with being overweight in late middle or old age and to assess whether weight change modifies this risk. Design: Longitudinal study of subjects in the epidemiological follow up study of the national health and nutrition examination survey I. Setting: United States. Subjects: 621 men and 960 women free of coronary heart disease in 1982-84 (mean age 77 years). Main outcome measure: Incidence of coronary heart disease. Results: Body mass index of 27 or more in late middle age was associated with increased risk of coronary heart disease in late life (relative risk=1.7 (95% confidence interval 1.3 to 2.1)) while body mass index of 27 or more in old age was not (1.1 (0.8 to 1.5)). This difference in risk was due largely to weight loss between middle and old age. Exclusion of those with weight loss of 10% or more increased risk associated with heavier weight in old age (1.4 (1.0 to 1.9)). Thinner older people who lost weight and heavier people who had gained weight showed increased risk of coronary heart disease compared with thinner people with stable weight. Conclusions: Heavier weight in late middle age was a risk factor for coronary heart disease in late life. Heavier weight in old age was associated with an increased risk once those with substantial weight loss were excluded. The contribution of weight to risk of coronary heart disease in older people may be underestimated if weight history is neglected. Key messages. Little is known about the effects of being overweight (defined as a body mass index of ≥27) in old age on risk of heart disease In this study older people who were overweight had an increased risk of coronary heart disease once weight history was accounted for Weight history, particularly in late middle age, is important in assessing risk of coronary disease in older people Older heavier people who gained more than 10% of midlife body weight or thinner older people who had lost 10% or more of body weight show high risk compared with thinner people with stable weight
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