BMI at 18 Could Be Predictor of Acute Coronary Syndrome Before 65

Results of a new study from a team of Swedish investigators is suggested that BMI at age of 18 could be used a predictor of early acute coronary events in men.

The population-based study, which was presented at the European Society of Cardiology (ESC) Congress 2019, found rising BMI in at 18 was associated with an elevated risk of a heart attack before age 65 — even after adjusting for factors including age, blood pressure, and fitness level.

"We show that BMI in the young is a remarkably strong risk marker that persists during life,” said Maria Aberg, MD, PhD, of the University of Gothenburg. “Our study supports close monitoring of BMI during puberty and preventing obesity with healthy eating and physical activity.”

To assess how BMI at age 18 predicts early acute coronary events in men in Sweden, investigators conducted a population-based study that included 1,668,921 individuals that were enlisted between 1968 and 2005. Investigators calculated a person’s risk of acute coronary event, which was defined as hospitalization for acute myocardial infarction or coronary death, during follow-up through use of Cox proportional hazards models.

Additionally, objective baseline measures of fitness and cognition were included in the models in a second set of analyses.

During the follow-up period, which lasted anywhere from 5 to 46 years, investigators noted 22,412 acute coronary events occurred in the study population. Of those who had an acute coronary event, the mean age at diagnosis was 50.2 years.

Compared to men with a BMI of 18.5 to 20 kg/m2, those with a BMI between 20 but less than 22.5 had a hazard ratio (HR) of 1.17 (1.12 to 1.43) and those with a BMI between 22.5 and less than 25 had an HR of 1.51 (1.44 to 1.59). Investigators noted HRs were calculated after adjusting for age, year of conscription, comorbidities at baseline, parental education, blood pressure, IQ, muscle strength, and fitness.

Among a group with a BMI of 35 or more, the HR was 3.47 (2.75 to 4.39) for an event before the age of 65. The multiple-adjusted risk per 1 unit increase in BMI was 1.10 (95% CI, 1.09 to 1.10).

"Our finding of a link between adolescent BMI and heart attack in adulthood supports our previous results for heart failure,” Aberg said. “As the prevalence of overweight and obesity in young adults continues to escalate, we may start to see correspondingly higher rates of heart attacks and strokes in the future.”



This study, “Body weight in adolescent men in Sweden and risk of an early acute coronary event,” was presented at ESC Congress 2019.