Body Mass Index in Young Women and Risk of Cardiomyopathy: A Long-Term Follow-Up Study in Sweden.
body mass index
cardiomyopathy
obesity
overweight
population
women
Journal
Circulation
ISSN: 1524-4539
Titre abrégé: Circulation
Pays: United States
ID NLM: 0147763
Informations de publication
Date de publication:
18 02 2020
18 02 2020
Historique:
entrez:
18
2
2020
pubmed:
18
2
2020
medline:
12
8
2020
Statut:
ppublish
Résumé
Incidence rates of cardiomyopathies, which are a common cause of heart failure in young people, have increased during the last decades. An association between body weight in adolescence and future cardiomyopathy among men was recently identified. Whether or not this holds true also for women is unknown. The aim was therefore to determine whether for young women being overweight or obese is associated with a higher risk of developing cardiomyopathy. This was a registry-based national prospective cohort study with data collected from the Swedish Medical Birth Register, 1982 to 2014, with up to 33 years of follow-up. Included women were of childbearing age (18-45 years) during the initial antenatal visit in their first or second pregnancy (n=1 393 346). We obtained baseline data on body mass index (BMI), smoking, education, and previous disorders. After exclusions, mainly because of previous disorders, the final sample was composed of 1 388 571 women. Cardiomyopathy cases were identified by linking the Medical Birth Register to the National Patient and Cause of Death registers. In total, we identified 1699 cases of cardiomyopathy (mean age at diagnosis, 46.2 [SD 9.1] years) during the follow-up with an incidence rate of 5.9 per 100 000 observation years. Of these, 481 were diagnosed with dilated cardiomyopathy, 246 had hypertrophic cardiomyopathy, 61 had alcohol/drug-induced cardiomyopathy, and 509 had other forms. The lowest risk for being diagnosed with a cardiomyopathy was detected at a BMI of 21 kg/m Elevated BMI among young women was associated with an increased risk of being diagnosed with a subsequent cardiomyopathy, especially dilated cardiomyopathy, starting already at mildly elevated body weight, whereas severe obesity entailed an almost 5-fold increase in risk. With the increasing numbers of persons who are overweight or obese, higher rates of cardiomyopathy can be expected in the future, along with an altered disease burden related to adiposity.
Sections du résumé
BACKGROUND
Incidence rates of cardiomyopathies, which are a common cause of heart failure in young people, have increased during the last decades. An association between body weight in adolescence and future cardiomyopathy among men was recently identified. Whether or not this holds true also for women is unknown. The aim was therefore to determine whether for young women being overweight or obese is associated with a higher risk of developing cardiomyopathy.
METHODS
This was a registry-based national prospective cohort study with data collected from the Swedish Medical Birth Register, 1982 to 2014, with up to 33 years of follow-up. Included women were of childbearing age (18-45 years) during the initial antenatal visit in their first or second pregnancy (n=1 393 346). We obtained baseline data on body mass index (BMI), smoking, education, and previous disorders. After exclusions, mainly because of previous disorders, the final sample was composed of 1 388 571 women. Cardiomyopathy cases were identified by linking the Medical Birth Register to the National Patient and Cause of Death registers.
RESULTS
In total, we identified 1699 cases of cardiomyopathy (mean age at diagnosis, 46.2 [SD 9.1] years) during the follow-up with an incidence rate of 5.9 per 100 000 observation years. Of these, 481 were diagnosed with dilated cardiomyopathy, 246 had hypertrophic cardiomyopathy, 61 had alcohol/drug-induced cardiomyopathy, and 509 had other forms. The lowest risk for being diagnosed with a cardiomyopathy was detected at a BMI of 21 kg/m
CONCLUSIONS
Elevated BMI among young women was associated with an increased risk of being diagnosed with a subsequent cardiomyopathy, especially dilated cardiomyopathy, starting already at mildly elevated body weight, whereas severe obesity entailed an almost 5-fold increase in risk. With the increasing numbers of persons who are overweight or obese, higher rates of cardiomyopathy can be expected in the future, along with an altered disease burden related to adiposity.
Identifiants
pubmed: 32065765
doi: 10.1161/CIRCULATIONAHA.119.044056
pmc: PMC7017947
doi:
Types de publication
Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
520-529Subventions
Organisme : British Heart Foundation
ID : RE/18/6/34217
Pays : United Kingdom
Références
Eur Heart J. 2014 Jan;35(1):25-32
pubmed: 23900697
Eur J Public Health. 2013 Apr;23(2):312-5
pubmed: 23002231
Diabetologia. 2011 Dec;54(12):3003-6
pubmed: 21959958
Am Heart J. 1993 Sep;126(3 Pt 1):632-40
pubmed: 8362719
Eur Heart J. 2014 Oct 14;35(39):2714-21
pubmed: 24944329
J Am Coll Cardiol. 2004 Apr 21;43(8):1399-404
pubmed: 15093874
Circulation. 2017 Mar 28;135(13):1214-1223
pubmed: 28174193
Nat Rev Cardiol. 2018 Apr;15(4):230-240
pubmed: 29022571
Eur J Prev Cardiol. 2018 Jan;25(2):173-180
pubmed: 29095053
Lancet. 2004 Jun 5;363(9424):1881-91
pubmed: 15183628
Eur J Heart Fail. 2018 May;20(5):873-878
pubmed: 29493068
ESC Heart Fail. 2018 Apr;5(2):233-240
pubmed: 29024504
Am J Obstet Gynecol. 1994 Jul;171(1):171-7
pubmed: 8030695
Scand J Public Health. 2015 Jul;43(5):534-9
pubmed: 25948091
JAMA. 1995 Jul 12;274(2):149-54
pubmed: 7596003
Prog Cardiovasc Dis. 2014 Jan-Feb;56(4):391-400
pubmed: 24438730
Heart Fail Rev. 2020 Mar;25(2):245-255
pubmed: 31267323
Circulation. 2019 Jul 9;140(2):117-125
pubmed: 31132859
Postgrad Med J. 1978 Jul;54(633):435-9
pubmed: 704513
Eur Heart J. 2008 Jan;29(2):270-6
pubmed: 17916581
Am J Public Health. 1997 Dec;87(12):1984-8
pubmed: 9431288
Circulation. 1989 Sep;80(3):564-72
pubmed: 2766509
Br J Biomed Sci. 2014;71(1):29-32
pubmed: 24693572
Obstet Gynecol. 1995 Aug;86(2):170-6
pubmed: 7617345
Obesity (Silver Spring). 2007 Jan;15(1):197-208
pubmed: 17228048
J Clin Endocrinol Metab. 2017 Aug 1;102(8):3011-3020
pubmed: 28666367
Br Heart J. 1984 Sep;52(3):327-31
pubmed: 6540593
Obstet Gynecol. 1994 Oct;84(4):565-73
pubmed: 8090394
Lancet. 2016 Aug 20;388(10046):776-86
pubmed: 27423262
BMC Public Health. 2010 Mar 09;10:119
pubmed: 20214805
Diabetologia. 2010 May;53(5):890-8
pubmed: 20146052
Obesity (Silver Spring). 2011 May;19(5):1069-76
pubmed: 20948517
Eur Heart J. 2018 May 21;39(20):1784-1793
pubmed: 29378019
J Intern Med. 2018 Nov;284(5):478-491
pubmed: 29331057
Eur J Heart Fail. 2014 Mar;16(3):238-47
pubmed: 24464619
Int J Obes (Lond). 2008 May;32(5):832-6
pubmed: 18087264
J Card Fail. 2017 May;23(5):363-369
pubmed: 27940334
Lancet. 2017 Dec 16;390(10113):2627-2642
pubmed: 29029897