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Obesity, overweight increase HF risk in postmenopausal women despite metabolic health

SAN ANTONIO — Postmenopausal women with obesity or overweight had elevated risk for HF regardless of whether they were metabolically healthy or unhealthy, according to research presented at the American Society for Preventive Cardiology Congress on CVD Prevention.

The study was selected as a winning Young Investigator poster at the 2019 meeting.

Amber R. Cordola Hsu, PhD, MPH , cardiovascular epidemiologist and assistant project scientist in the department of medicine at UC Irvine School of Medicine, and colleagues analyzed data from 19,516 CVD biomarker assays of participants in the Women’s Health Initiative who were free from prevalent CVD. The researchers collected information on total cholesterol, HDL, triglycerides and glucose, C-reactive protein and insulin.

Women were categorized by metabolic status and weight: metabolically healthy normal weight, metabolically unhealthy normal weight, metabolically healthy overweight/obese or metabolically unhealthy overweight/obese.

During a mean follow-up of 11.3 years, the primary outcome of incident HF hospitalization occurred in 456 women. The women with incident HF were more likely than those without HF to be older, (66.8 years vs. 63.2 years), white (60.5% vs. 46.6%), have some college education (40.8% vs. 39.4%) and have a low income (33.3% earned less than $19,999 per year vs. 23.5%). These women with HF were also more likely to report smoking (52.2% vs. 46.9%), report less physically active per week (61.3 minutes vs. 84.9 minutes), have a higher BMI (32.1 kg/m2 vs. 29.5 kg/m2) and higher systolic BP (139.1 mm Hg vs. 129.3 mm Hg).

When the researchers evaluated HF risk by metabolic and weight status, risk was increased among the women with metabolically healthy overweight/obese (HR = 1.45; 95% CI, 1.02-2.06) and metabolically unhealthy overweight/obese (HR = 2.48; 95% CI, 1.98-3.12), compared with those with metabolically healthy normal weight. There was also a modest trend toward heightened HF risk among women with metabolically unhealthy normal weight compared with those with metabolically healthy normal weight (HR = 1.35; 95% CI, 0.94-1.93).

The researchers reported an independent association between risk for incident HF and prevalent diabetes, age and smoking.

Postmenopausal women with a healthy cardiometabolic status in the presence of obesity does not protect against HF,” Hsu said during the presentation. – by Darlene Dobkowski

Reference:

Hsu ARC. Session 4: Young Investigator Presentations. Presented at: American Society for Preventive Cardiology Congress on CVD Prevention; July 19-21, 2019; San Antonio.

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