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Weight Change and the Onset of Cardiovascular Diseases: Emulating Trials Using Electronic Health Records
Cross-sectional measures of body mass index (BMI) are associated with cardiovascular disease (CVD) incidence, but less is known about whether weight change affects the risk of CVD. METHODS: We estimated the effect of 2-y weight change interventions on 7-y risk of CVD (CVD death, myocardial infarctio...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318567/ https://www.ncbi.nlm.nih.gov/pubmed/34348396 http://dx.doi.org/10.1097/EDE.0000000000001393 |
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author | Katsoulis, Michail Stavola, Bianca D. Diaz-Ordaz, Karla Gomes, Manuel Lai, Alvina Lagiou, Pagona Wannamethee, Goya Tsilidis, Konstantinos Lumbers, R. Thomas Denaxas, Spiros Banerjee, Amitava Parisinos, Constantinos A. Batterham, Rachel Patel, Riyaz Langenberg, Claudia Hemingway, Harry |
author_facet | Katsoulis, Michail Stavola, Bianca D. Diaz-Ordaz, Karla Gomes, Manuel Lai, Alvina Lagiou, Pagona Wannamethee, Goya Tsilidis, Konstantinos Lumbers, R. Thomas Denaxas, Spiros Banerjee, Amitava Parisinos, Constantinos A. Batterham, Rachel Patel, Riyaz Langenberg, Claudia Hemingway, Harry |
author_sort | Katsoulis, Michail |
collection | PubMed |
description | Cross-sectional measures of body mass index (BMI) are associated with cardiovascular disease (CVD) incidence, but less is known about whether weight change affects the risk of CVD. METHODS: We estimated the effect of 2-y weight change interventions on 7-y risk of CVD (CVD death, myocardial infarction, stroke, hospitalization from coronary heart disease, and heart failure) by emulating hypothetical interventions using electronic health records. We identified 138,567 individuals with 45–69 years of age without chronic disease in England from 1998 to 2016. We performed pooled logistic regression, using inverse-probability weighting to adjust for baseline and time-varying confounders. We categorized each individual into a weight loss, maintenance, or gain group. RESULTS: Among those of normal weight, both weight loss [risk difference (RD) vs. weight maintenance = 1.5% (0.3% to 3.0%)] and gain [RD = 1.3% (0.5% to 2.2%)] were associated with increased risk for CVD compared with weight maintenance. Among overweight individuals, we observed moderately higher risk of CVD in both the weight loss [RD = 0.7% (−0.2% to 1.7%)] and the weight gain group [RD = 0.7% (−0.1% to 1.7%)], compared with maintenance. In the obese, those losing weight showed lower risk of coronary heart disease [RD = −1.4% (−2.4% to −0.6%)] but not of stroke. When we assumed that chronic disease occurred 1–3 years before the recorded date, estimates for weight loss and gain were attenuated among overweight individuals; estimates for loss were lower among obese individuals. CONCLUSION: Among individuals with obesity, the weight-loss group had a lower risk of coronary heart disease but not of stroke. Weight gain was associated with increased risk of CVD across BMI groups. See video abstract at, http://links.lww.com/EDE/B838. |
format | Online Article Text |
id | pubmed-8318567 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-83185672021-08-02 Weight Change and the Onset of Cardiovascular Diseases: Emulating Trials Using Electronic Health Records Katsoulis, Michail Stavola, Bianca D. Diaz-Ordaz, Karla Gomes, Manuel Lai, Alvina Lagiou, Pagona Wannamethee, Goya Tsilidis, Konstantinos Lumbers, R. Thomas Denaxas, Spiros Banerjee, Amitava Parisinos, Constantinos A. Batterham, Rachel Patel, Riyaz Langenberg, Claudia Hemingway, Harry Epidemiology Chronic Diseases Cross-sectional measures of body mass index (BMI) are associated with cardiovascular disease (CVD) incidence, but less is known about whether weight change affects the risk of CVD. METHODS: We estimated the effect of 2-y weight change interventions on 7-y risk of CVD (CVD death, myocardial infarction, stroke, hospitalization from coronary heart disease, and heart failure) by emulating hypothetical interventions using electronic health records. We identified 138,567 individuals with 45–69 years of age without chronic disease in England from 1998 to 2016. We performed pooled logistic regression, using inverse-probability weighting to adjust for baseline and time-varying confounders. We categorized each individual into a weight loss, maintenance, or gain group. RESULTS: Among those of normal weight, both weight loss [risk difference (RD) vs. weight maintenance = 1.5% (0.3% to 3.0%)] and gain [RD = 1.3% (0.5% to 2.2%)] were associated with increased risk for CVD compared with weight maintenance. Among overweight individuals, we observed moderately higher risk of CVD in both the weight loss [RD = 0.7% (−0.2% to 1.7%)] and the weight gain group [RD = 0.7% (−0.1% to 1.7%)], compared with maintenance. In the obese, those losing weight showed lower risk of coronary heart disease [RD = −1.4% (−2.4% to −0.6%)] but not of stroke. When we assumed that chronic disease occurred 1–3 years before the recorded date, estimates for weight loss and gain were attenuated among overweight individuals; estimates for loss were lower among obese individuals. CONCLUSION: Among individuals with obesity, the weight-loss group had a lower risk of coronary heart disease but not of stroke. Weight gain was associated with increased risk of CVD across BMI groups. See video abstract at, http://links.lww.com/EDE/B838. Lippincott Williams & Wilkins 2021-07-28 2021-09 /pmc/articles/PMC8318567/ /pubmed/34348396 http://dx.doi.org/10.1097/EDE.0000000000001393 Text en Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Chronic Diseases Katsoulis, Michail Stavola, Bianca D. Diaz-Ordaz, Karla Gomes, Manuel Lai, Alvina Lagiou, Pagona Wannamethee, Goya Tsilidis, Konstantinos Lumbers, R. Thomas Denaxas, Spiros Banerjee, Amitava Parisinos, Constantinos A. Batterham, Rachel Patel, Riyaz Langenberg, Claudia Hemingway, Harry Weight Change and the Onset of Cardiovascular Diseases: Emulating Trials Using Electronic Health Records |
title | Weight Change and the Onset of Cardiovascular Diseases: Emulating Trials Using Electronic Health Records |
title_full | Weight Change and the Onset of Cardiovascular Diseases: Emulating Trials Using Electronic Health Records |
title_fullStr | Weight Change and the Onset of Cardiovascular Diseases: Emulating Trials Using Electronic Health Records |
title_full_unstemmed | Weight Change and the Onset of Cardiovascular Diseases: Emulating Trials Using Electronic Health Records |
title_short | Weight Change and the Onset of Cardiovascular Diseases: Emulating Trials Using Electronic Health Records |
title_sort | weight change and the onset of cardiovascular diseases: emulating trials using electronic health records |
topic | Chronic Diseases |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318567/ https://www.ncbi.nlm.nih.gov/pubmed/34348396 http://dx.doi.org/10.1097/EDE.0000000000001393 |
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