Risk of heart attack and stroke is higher in young people who are over ten years obese

Men under 65 and women under 50 who have been overweight or obese for 10 years are at increased risk of heart attacks and strokes, according to new research presented at the annual meeting of the Endocrine Society ENDO 2024.

For this study, which has not yet been published in a peer-reviewed journal, researchers used data from the Nurses' Health Study and the Health Professionals Follow-Up Study. They analyzed medical information on 109,259 women and 27,239 men with a body mass index (BMI) above 25, and also examined the incidence of heart attacks and strokes between 2000 and 2020. During the study, 12,048 cardiovascular events were recorded.

In women under 50 and men under 65 who had been obese for 10 years or more, scientists found the following:

• The risk of heart attack and stroke increased by 25-60%.
• There was no increased risk in women over 50 years of age and men over 65 years of age.

Based on these data, the researchers concluded that the earlier a person begins treatment for obesity, the better for their cardiovascular health.

“Excess weight is harmful if it is present for a long time,” said lead study author Dr. Andrew Turchin, director of quality in the Division of Endocrinology at Brigham & Women's Hospital and assistant professor of medicine at Harvard Medical School in Boston. “Preventing this—through early treatment of obesity—can prevent complications and improve outcomes for patients. These findings show healthcare professionals that timely intervention is key to preventing obesity-related complications. Now that there are more options to help overweight and obese people lose weight, healthcare professionals must quickly offer these methods to their patients."

The relationship between obesity and general health

Dr. Sean Heffron, a cardiologist at NYU Langone Health in New York, studies the link between heart health and obesity.

“This is a very important topic that I am currently researching,” said Heffron, who was not involved in the study. “Without access to the full text of the study, it is difficult to draw definitive conclusions. However, it may be that in cases where the overall burden of obesity is lower, people were generally healthier and lived into old age without other medical conditions."

In a review article published in 2023, Heffron and colleagues described how the degree and duration of obesity has different effects on health.

He detailed the conditions and the impact of obesity on them:

• Hypertension – degree of obesity has a more significant effect than duration.
• Type 2 diabetes - duration of obesity has a more significant effect than degree.
• Dyslipidemia – degree of obesity has a more significant effect than duration.
• Cardiovascular and overall mortality, atherosclerotic cardiovascular disease (ASCVD) and cardiomyopathy - both duration and extent are important.

"This new study looked at how obesity affects different age groups," said Dr. Michelle Weinberg, a cardiologist at Providence Saint John's Health Center in California who was not involved in the study. “The middle age group had the greatest risk. The younger group had a lower disease burden due to shorter duration of obesity. The older group observed some protective benefits of being overweight. The middle group shows how a high BMI can negatively impact your health.”

Obesity in old age

Older adults have a lower risk of heart attacks and strokes associated with obesity than younger people, a new study shows.

This obesity paradox stems from counterintuitive findings indicating that although overweight or obese people have a higher risk of developing heart problems, once a person develops heart disease, those with a higher BMI are less likely to die. Than people of average weight.

Various explanations have been proposed, including the fact that once a person has developed heart problems, some excess weight may somehow protect against further health problems and death, especially since people with serious and chronic diseases often lose weight.

“We have long known that obesity is a risk factor for cardiovascular disease, so the results of the current study are not surprising,” said Dr. Chang-Han Chen, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in California..

Being overweight appears to be protective for older people.

“This study is consistent with other studies that indicate that being overweight in later life may protect against certain diseases,” said Chen, who was not involved in the study. “It is well known that the risk decreases with age; older people with higher BMI tend to have better cardiovascular outcomes. This could mean that being overweight shows how tough they are. They are not fragile and sick. We don't know exactly why older people who are overweight are healthier and fitter.”

“However, the study highlights the need to develop a heart-healthy lifestyle during your younger years. I tell my patients about Life's Essential 8 from the American Heart Association, which provides a roadmap to better heart health. One of the points is maintaining a healthy weight and following the principles of healthy eating,” Chen added.