Body mass index modifies cardiovascular risk trajectory: a Chinese longitudinal cohort study

Area of Science:

• Epidemiology
• Cardiovascular Disease Research
• Public Health

Background:

• Cardiovascular disease (CVD) risk progression throughout life and the impact of body mass index (BMI) remain unclear.
• Understanding these trajectories is crucial for effective public health interventions.

Purpose of the Study:

• To investigate the life course changes in cardiovascular disease (CVD) risk among Chinese adults.
• To determine the influence of normal body mass index (BMI) on CVD risk trajectory and identify potential benefits.

Main Methods:

• Analysis of a large Chinese longitudinal cohort (106,962 participants, ages 35-74) with repeated measurements from 1992-2021.
• Application of the China-PAR equation for 10-year CVD risk assessment.
• Utilized general additive mixed and Joinpoint models to analyze risk trajectories and BMI effects.

Main Results:

• 10-year CVD risk dramatically increased from 1.11% to 14.87% between ages 35-74, reaching moderate and high-risk levels at 53 and 65 years.
• Normal BMI (<25 kg/m²) slowed CVD risk increase (0.33% vs. 0.42% slope) and postponed moderate/high-risk age by 4-5 years compared to overweight/obesity (BMI ≥25 kg/m²).
• The risk difference between normal and overweight/obese groups grew significantly with age, with women showing sustained benefits and men peaking at 53 years.

Conclusions:

• Cardiovascular risk significantly increases across the adult life course in China.
• Maintaining a normal BMI offers substantial cardiovascular benefits, delaying the onset of moderate and high-risk thresholds.
• Normal BMI is a critical modifiable factor for cardiovascular risk reduction, particularly impactful for women.