CVD Risk Unrelated to Weight in Metabolically Healthy Women

Metabolically healthy women have the same cardiovascular disease (CVD) risk regardless of their body mass index (BMI), according to a new study.

Researchers at Gentofte Hospital (Hellerup, Denmark) used the Danish national health databases to follow 261,489 women (mean age 31 years) who had given birth during 2004-2009, with no prior history of CVD disease. The women were divided into four categories according to their pre-pregnancy body mass index (BMI) and presence of metabolic disorders, and were followed for five years after childbirth. Metabolic disorders were defined by claimed prescription data, and discharge diagnoses and data on cause of death were used to determine if the women had a heart attack, a stroke, or died; pregnancy-associated metabolic disorders were defined using diagnosis codes.

The results showed that being overweight but metabolically healthy is not associated with an excess CVD risk in comparison with normal weight healthy women; metabolically unhealthy, overweight women, however, had an almost 7-fold increased risk of heart attack and a 4-fold increased risk of stroke. The authors claim, however, that the results suggest that development of metabolic disorders, for which obesity is a major determinant, is associated with a marked increase in CVD, even in the short term. The study was presented at the 2013 European Society of Cardiology (ESC) Congress, held during September 2013 in Amsterdam (The Netherlands).

“Obesity might not be all bad if the overweight woman has not developed any hypertensive disorders, disorders in glucose-metabolism or elevated cholesterol levels,” said study presenter and coauthor Michelle Schmiegelow, MD. “But because obesity markedly increases the risk of developing these metabolic disorders, these women most likely have a window of opportunity to lose weight and change their prognosis."

Metabolic disorders include hypertensive disorders, such as hypertension, gestational hypertension, or pre-eclampsia; disorders in glucose-metabolism, such as diabetes and gestational diabetes; and elevated cholesterol levels (dyslipidemia).

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