Abstract P250: Overweight and Obesity are Independent Risk Factors for Coronary Heart Disease, and have Similar Associations for Women and Men: A Meta-Analysis of 94 Cohorts with 1.1 Million Participants

Introduction: Risk for coronary heart disease differs by sex, with women developing disease later than men. This difference might be explained by sexual dimorphisms in body composition. We hypothesized that the relationship between body mass index and coronary heart disease would be different for women and men, with men having higher risk at the same level of body mass index.Methods: Published studies reporting the longitudinal association between body mass index and coronary heart disease in women and men in general populations up to August 19th, 2013 were included from systematic searches in Pubmed/Medline and EMBASE. Also included were individual participant data from 4 large studies. Data were pooled using random effects models with inverse variance weighting.Results: Data from 94 cohorts, 1,119,201 participants, and 34,191 incident cases of coronary heart disease were included. Higher body mass index was significantly associated with age-adjusted incident coronary heart disease in women (one unit body mass index Hazard Ratio=1.04 (1.03-1.05), overweight HR=1.21 (1.13-1.31), obese HR=1.62 (1.42-1.84)) and men (corresponding HRs=1.05 (1.03-1.07), 1.21 (1.10-1.32), 1.59 (1.41-1.80)). Overall, there was no difference in the hazard ratios by sex (Figure). The HR for women/men for one unit difference in body mass index was 0.99 (0.98-1.01) and for categories of body mass index the HR for overweight 1.01(0.93-1.09) and for obese 1.07(0.97-1.19). The results were similar for multiple-adjustment and for a range of sensitivity analyses.Conclusion: Overweight and obese women and men have a similar elevated risk for coronary heart disease. Public health campaigns to reduce adiposity are likely to favor each sex substantially, and equally. ![][1] [1]: /embed/graphic-1.gif