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Reducing the population burden of coronary heart disease by modifying adiposity: Estimates from the ARIC study

Journal of the American Heart Association Feb 13, 2020

Gellert KS, Keil AP, Zeng D, et al. - Given that excess adiposity raises coronary heart disease (CHD) risk in an association that manifests below conventional obesity cut points, researchers undertook this inquiry in 13,610 ARIC (Atherosclerosis Risk in Communities) participants, to estimate how CHD incidence is influenced by hypothetical decreases in both body mass index (BMI) and waist circumference (WC). Experts applied their hypothetical decrease in BMI or WC relative to the temporal trend, with no hypothetical decrease in those with BMI > 24 or WC > 88 cm, respectively. This threshold for the hypothetical decline was near the clinical guidelines for excess adiposity. After the hypothetical BMI and WC decrease, the risk differences were estimated to be −0.6% and −1.0%, respectively. Of overall CHD events reported over 12 years in this study sample, 9% and 16% could have been averted by a hypothetical reduction of 5% in BMI and WC, respectively, as noted following adjustment for established CHD risk factors. Experts concluded that modest decreases in adiposity, achievable via lifestyle modification, could provide meaningful CHD risk reductions.
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