Related Experiment Video
Updated: May 6, 2026
Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Body mass index and incident hospitalisation for cardiovascular disease in 158 546 participants from the 45 and Up
G Joshy1, R J Korda2, J Attia3
1National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.
Objective:
To investigate the relationship between fine gradations in body mass index (BMI) and risk of hospitalisation for different types of cardiovascular disease (CVD).
Design, Subjects And Methods:
The 45 and Up Study is a large-scale Australian cohort study initiated in 2006. Self-reported data from 158 546 individuals with no history of CVD were linked prospectively to hospitalisation and mortality data. Hazard ratios (HRs) of incident hospitalisation for specific CVD diagnoses in relation to baseline BMI categories were estimated using Cox regression, adjusting for age, sex, region of residence, income, education, smoking, alcohol intake and health insurance status.
Results:
There were 9594 incident CVD admissions over 583 100 person-years among people with BMI≥20 kg m(-2), including 3096 for ischaemic heart disease (IHD), 1373 for stroke, 411 for peripheral vascular disease (PVD) and 320 for heart failure. The adjusted HR of hospitalisation for all CVD diagnoses combined increased significantly with increasing BMI (P(trend) <0.0001)). The HR of IHD hospitalisation increased by 23% (95% confidence interval (95% CI): 18-27%) per 5 kg m(-2) increase in BMI (compared to BMI 20.0-22.49 kg m(-2), HR (95% CI) for BMI categories were: 22.5-24.99=1.25 (1.08-1.44); 25-27.49=1.43 (1.24-1.65); 27.5-29.99=1.64 (1.42-1.90); 30-32.49=1.63 (1.39-1.91) and 32.5-50=2.10 (1.79-2.45)). The risk of hospitalisation for heart failure showed a significant, but nonlinear, increase with increasing BMI. No significant increase was seen with above-normal BMI for stroke or PVD. For other specific classifications of CVD, HRs of hospitalisation increased significantly with increasing BMI for: hypertension; angina; acute myocardial infarction; chronic IHD; pulmonary embolism; non-rheumatic aortic valve disorders; atrioventricular and left bundle-branch block; atrial fibrillation and flutter; aortic aneurysm; and phlebitis and thrombophlebitis.
Conclusion:
The risk of hospitalisation for a wide range of CVD subtypes increases with relatively fine increments in BMI. Obesity prevention strategies are likely to benefit from focusing on bringing down the mean BMI at the population level, in addition to targeting those with a high BMI.
Related Concept Videos
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:24Obesity
01:26Coronary Artery Disease IV: Preventive Measures
01:30Coronary Artery Disease I: Introduction
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT