Association of obesity with cardiovascular disease mortality in the PLCO trial

ObjectiveObesity is a risk factor for cardiovascular disease (CVD) mortality, but the association between obesity and specific causes of CVD mortality is still under investigation.MethodWe prospectively examined body-mass index (BMI) in relation to CVD-specific causes of death in approximately 86,000 US men and women in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, followed for up to 13 years. BMI was calculated from self-reported weight and height at baseline. Hazard ratios (HRs) were calculated overall and stratified by sex, smoking status, and educational level.ResultOverweight non-obese participants (BMI: 25.0–29.9) were not at excess risk for CVD mortality (HR and CIs are 1.02 [0.92–1.13]), compared to participants of normal BMI (18.5–24.9). Excess CVD mortality was observed for participants of BMI 30.0–34.9 (HR and CIs: 1.29 [1.13–1.48]), BMI 35.0–39.9 (HR and CIs: 1.87 [1.51–2.32]) and BMI 40.0 + (HR and CIs: 2.21 [1.57–3.21]) (p < 0.001 for trend). BMI was unrelated to mortality due to stroke. The observed association of BMI with CVD was independent of gender, smoking status and educational level.ConclusionObesity is associated with increased mortality due to CVD.

•We prospectively examined BMI in relation to CVD-specific causes of death in approximately 86,000 US men and women, followed for up to 13 years.•Obesity is associated with increased mortality due to CVD.•The observed association of BMI with CVD was independent of gender, smoking status and educational level.