Being Overweight, Obese Better Predictor of Heart
Disease Than Metabolic Syndrome
Metabolic syndrome not the critical risk; Findings
put emphasis on achieving and maintaining a healthy body weight
(typically, BMI of 18.5 to 25.0) is of paramount importance
Nov. 11, 2013 Being overweight or obese are risk
factors for myocardial infarction (heart attack) and ischemic heart
disease (IHD) regardless of whether individuals also have the cluster of
cardiovascular risk factors known as metabolic syndrome, which includes
high blood pressure, high cholesterol and high blood sugar, according to
a study published by JAMA Internal Medicine, a JAMA Network
Being overweight or obese likely causes MI and IHD
but whether co-existing metabolic syndrome is necessary for the
conditions to develop has beeb unknown, according to the study authors.
During nearly four years of follow-up, researchers
identified 634 cases of MIs and 1,781 cases of IHDs. Relative to people
with normal weight, the hazards of MI were increased with overweight and
obesity and were statistically equivalent whether or not patients had
There were also increasing cumulative incidences of
MI and IHD among individuals both with and without metabolic syndrome
from normal weight through overweight to obese individuals, according to
the study by Bψrge G. Nordestgaard, M.D., D. M.Sc., and Mette Thomsen,
M.D., from Herlev Hospital, Copenhagen University Hospital, Denmark.
The researchers investigated the associations by
examining data from 71,527 participants in a general population study.
These findings suggest that overweight and obesity
are risk factors for MI and IHD regardless of the presence or absence of
metabolic syndrome and that metabolic syndrome is no more valuable than
BMI (body mass index) in identifying individuals at risk, the study
This research was supported by Herlev Hospital,
Copenhagen University Hospital, the Copenhagen County Foundation, and
the University of Copenhagen.
Commentary: Maintaining a Healthy Body Weight is
In a related commentary, Chandra L. Jackson, Ph.D.,
M.S., and Meir J. Stampfer, M.D., Dr.P.H., of the Harvard School of
Public Health, Boston, write: Besides questions related to how much
added value there is to assessing MetS [metabolic syndrome] (beyond its
component elements), the findings from this study have important
implications and clearly corroborate the clinical and public health
message that adiposity is not benign and that achieving and maintaining
a healthy body weight (typically, BMI [body mass index], >18.5 to <25.0
kg/m) is of paramount importance.
The findings of Thomsen and Nordestgaard add
important new evidence to counter the common belief in the scientific
and lay communities that the adverse health effects of overweight are
generally inconsequential as long as the individual is metabolically
healthy, they continue.
In contrast, this study adds further evidence for
the increased risks associated with overweight, even among those who
might be considered metabolically healthy. These results also underscore
the importance of focusing on weight gain prevention due to the
difficulty in achieving and maintaining weight loss to reverse being
overweight or obese, they conclude.