Body mass index and risk of stroke and myocardial infarction in a relatively lean population meta-analysis of 16 Japanese cohorts using individual data

Hiroshi Yatsuya, Hideaki Toyoshima, Kazumasa Yamagishi, Koji Tamakoshi, Masataka Taguri, Akiko Harada, Yasuo Ohashi, Yoshikuni Kita, Yoshihiko Naito, Michiko Yamada, Naohito Tanabe, Hiroyasu Iso, Hirotsugu Ueshima

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Abstract

Background: The association of overweight/obesity with the incidence of cardiovascular diseases, especially stroke, has not been comprehensively examined in relatively lean populations in which stroke is more prevalent than coronary heart disease. Methods and Results: Pooled individual data from 16 Japanese cohorts comprising 45 235 participants ages 40 to 89 years without previous history of cardiovascular disease were studied. During follow-up, 1113 incident strokes and 190 myocardial infarctions were identified. At baseline, mean ages of men and women were 55.4 and 56.5 years and mean body mass indices (BMI) were 23.0 and 23.4 kg/m2, respectively. Compared with those with BMI <21.0, incidence rates of cerebral infarction in subjects with BMI ≥27.5 were significantly elevated in both men (hazard ratio, 1.81; 95% confidence interval [CI], 1.28 to 2.56) and women (hazard ratio, 1.65; 95% CI, 1.23 to 2.21), adjusted for age, smoking, and drinking habit. Incidence of cerebral hemorrhage was also associated positively with BMI in both men (hazard ratio, 2.51; 95% CI, 1.21 to 5.20) and women (hazard ratio, 1.98; 95% CI, 1.12 to 3.52). Adjustment for systolic blood pressure, a mediating factor, significantly attenuated most BMI association with stroke in both sexes. For myocardial infarction, the hazard ratio was 3.16 (95% CI, 1.66 to 6.01) for BMI 27.5 or greater versus less than 21.0 only in men, which appeared partly mediated by total cholesterol and SBP. Conclusions: Overweight/obesity was associated with an increased risk of cerebral infarction and hemorrhage in men and women and myocardial infarction in men. Weight control may have the potential to prevent both stroke and myocardial infarction in Japan.

Original languageEnglish
Pages (from-to)498-505
Number of pages8
JournalCirculation: Cardiovascular Quality and Outcomes
Volume3
Issue number5
DOIs
Publication statusPublished - 01-09-2010

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Meta-Analysis
Body Mass Index
Stroke
Myocardial Infarction
Confidence Intervals
Population
Cerebral Infarction
Cerebral Hemorrhage
Incidence
Cardiovascular Diseases
Obesity
Blood Pressure
Drinking
Habits
Coronary Disease
Japan
Smoking
Cholesterol
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Yatsuya, Hiroshi ; Toyoshima, Hideaki ; Yamagishi, Kazumasa ; Tamakoshi, Koji ; Taguri, Masataka ; Harada, Akiko ; Ohashi, Yasuo ; Kita, Yoshikuni ; Naito, Yoshihiko ; Yamada, Michiko ; Tanabe, Naohito ; Iso, Hiroyasu ; Ueshima, Hirotsugu. / Body mass index and risk of stroke and myocardial infarction in a relatively lean population meta-analysis of 16 Japanese cohorts using individual data. In: Circulation: Cardiovascular Quality and Outcomes. 2010 ; Vol. 3, No. 5. pp. 498-505.
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abstract = "Background: The association of overweight/obesity with the incidence of cardiovascular diseases, especially stroke, has not been comprehensively examined in relatively lean populations in which stroke is more prevalent than coronary heart disease. Methods and Results: Pooled individual data from 16 Japanese cohorts comprising 45 235 participants ages 40 to 89 years without previous history of cardiovascular disease were studied. During follow-up, 1113 incident strokes and 190 myocardial infarctions were identified. At baseline, mean ages of men and women were 55.4 and 56.5 years and mean body mass indices (BMI) were 23.0 and 23.4 kg/m2, respectively. Compared with those with BMI <21.0, incidence rates of cerebral infarction in subjects with BMI ≥27.5 were significantly elevated in both men (hazard ratio, 1.81; 95{\%} confidence interval [CI], 1.28 to 2.56) and women (hazard ratio, 1.65; 95{\%} CI, 1.23 to 2.21), adjusted for age, smoking, and drinking habit. Incidence of cerebral hemorrhage was also associated positively with BMI in both men (hazard ratio, 2.51; 95{\%} CI, 1.21 to 5.20) and women (hazard ratio, 1.98; 95{\%} CI, 1.12 to 3.52). Adjustment for systolic blood pressure, a mediating factor, significantly attenuated most BMI association with stroke in both sexes. For myocardial infarction, the hazard ratio was 3.16 (95{\%} CI, 1.66 to 6.01) for BMI 27.5 or greater versus less than 21.0 only in men, which appeared partly mediated by total cholesterol and SBP. Conclusions: Overweight/obesity was associated with an increased risk of cerebral infarction and hemorrhage in men and women and myocardial infarction in men. Weight control may have the potential to prevent both stroke and myocardial infarction in Japan.",
author = "Hiroshi Yatsuya and Hideaki Toyoshima and Kazumasa Yamagishi and Koji Tamakoshi and Masataka Taguri and Akiko Harada and Yasuo Ohashi and Yoshikuni Kita and Yoshihiko Naito and Michiko Yamada and Naohito Tanabe and Hiroyasu Iso and Hirotsugu Ueshima",
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Yatsuya, H, Toyoshima, H, Yamagishi, K, Tamakoshi, K, Taguri, M, Harada, A, Ohashi, Y, Kita, Y, Naito, Y, Yamada, M, Tanabe, N, Iso, H & Ueshima, H 2010, 'Body mass index and risk of stroke and myocardial infarction in a relatively lean population meta-analysis of 16 Japanese cohorts using individual data', Circulation: Cardiovascular Quality and Outcomes, vol. 3, no. 5, pp. 498-505. https://doi.org/10.1161/CIRCOUTCOMES.109.908517

Body mass index and risk of stroke and myocardial infarction in a relatively lean population meta-analysis of 16 Japanese cohorts using individual data. / Yatsuya, Hiroshi; Toyoshima, Hideaki; Yamagishi, Kazumasa; Tamakoshi, Koji; Taguri, Masataka; Harada, Akiko; Ohashi, Yasuo; Kita, Yoshikuni; Naito, Yoshihiko; Yamada, Michiko; Tanabe, Naohito; Iso, Hiroyasu; Ueshima, Hirotsugu.

In: Circulation: Cardiovascular Quality and Outcomes, Vol. 3, No. 5, 01.09.2010, p. 498-505.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Body mass index and risk of stroke and myocardial infarction in a relatively lean population meta-analysis of 16 Japanese cohorts using individual data

AU - Yatsuya, Hiroshi

AU - Toyoshima, Hideaki

AU - Yamagishi, Kazumasa

AU - Tamakoshi, Koji

AU - Taguri, Masataka

AU - Harada, Akiko

AU - Ohashi, Yasuo

AU - Kita, Yoshikuni

AU - Naito, Yoshihiko

AU - Yamada, Michiko

AU - Tanabe, Naohito

AU - Iso, Hiroyasu

AU - Ueshima, Hirotsugu

PY - 2010/9/1

Y1 - 2010/9/1

N2 - Background: The association of overweight/obesity with the incidence of cardiovascular diseases, especially stroke, has not been comprehensively examined in relatively lean populations in which stroke is more prevalent than coronary heart disease. Methods and Results: Pooled individual data from 16 Japanese cohorts comprising 45 235 participants ages 40 to 89 years without previous history of cardiovascular disease were studied. During follow-up, 1113 incident strokes and 190 myocardial infarctions were identified. At baseline, mean ages of men and women were 55.4 and 56.5 years and mean body mass indices (BMI) were 23.0 and 23.4 kg/m2, respectively. Compared with those with BMI <21.0, incidence rates of cerebral infarction in subjects with BMI ≥27.5 were significantly elevated in both men (hazard ratio, 1.81; 95% confidence interval [CI], 1.28 to 2.56) and women (hazard ratio, 1.65; 95% CI, 1.23 to 2.21), adjusted for age, smoking, and drinking habit. Incidence of cerebral hemorrhage was also associated positively with BMI in both men (hazard ratio, 2.51; 95% CI, 1.21 to 5.20) and women (hazard ratio, 1.98; 95% CI, 1.12 to 3.52). Adjustment for systolic blood pressure, a mediating factor, significantly attenuated most BMI association with stroke in both sexes. For myocardial infarction, the hazard ratio was 3.16 (95% CI, 1.66 to 6.01) for BMI 27.5 or greater versus less than 21.0 only in men, which appeared partly mediated by total cholesterol and SBP. Conclusions: Overweight/obesity was associated with an increased risk of cerebral infarction and hemorrhage in men and women and myocardial infarction in men. Weight control may have the potential to prevent both stroke and myocardial infarction in Japan.

AB - Background: The association of overweight/obesity with the incidence of cardiovascular diseases, especially stroke, has not been comprehensively examined in relatively lean populations in which stroke is more prevalent than coronary heart disease. Methods and Results: Pooled individual data from 16 Japanese cohorts comprising 45 235 participants ages 40 to 89 years without previous history of cardiovascular disease were studied. During follow-up, 1113 incident strokes and 190 myocardial infarctions were identified. At baseline, mean ages of men and women were 55.4 and 56.5 years and mean body mass indices (BMI) were 23.0 and 23.4 kg/m2, respectively. Compared with those with BMI <21.0, incidence rates of cerebral infarction in subjects with BMI ≥27.5 were significantly elevated in both men (hazard ratio, 1.81; 95% confidence interval [CI], 1.28 to 2.56) and women (hazard ratio, 1.65; 95% CI, 1.23 to 2.21), adjusted for age, smoking, and drinking habit. Incidence of cerebral hemorrhage was also associated positively with BMI in both men (hazard ratio, 2.51; 95% CI, 1.21 to 5.20) and women (hazard ratio, 1.98; 95% CI, 1.12 to 3.52). Adjustment for systolic blood pressure, a mediating factor, significantly attenuated most BMI association with stroke in both sexes. For myocardial infarction, the hazard ratio was 3.16 (95% CI, 1.66 to 6.01) for BMI 27.5 or greater versus less than 21.0 only in men, which appeared partly mediated by total cholesterol and SBP. Conclusions: Overweight/obesity was associated with an increased risk of cerebral infarction and hemorrhage in men and women and myocardial infarction in men. Weight control may have the potential to prevent both stroke and myocardial infarction in Japan.

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