IMPACT OF BODY-MASS INDEX ON CORONARY HEART-DISEASE RISK-FACTORS IN MEN AND WOMEN - THE FRAMINGHAM OFFSPRING STUDY

Increased body weight has been associated with an increased risk of mo rbidity and mortality from coronary heart disease (CHD) in several pop ulations. We studied the distribution of body mass index (BMI, kg/m(2) ) in men (n=1566; mean age, 49+/-10 years) and women (n=1627; mean age , 49+/-10 years) participating in the third examination cycle of the F ramingham Offspring Study and the association of BMI with known CHD ri sk factors. In men, BMI increased with age until age 50 years, when it reached a plateau. In women, there was a trend toward an increase in BMI with age up to the seventh decade of life. Seventy-two percent of men and 42% of women had a BMI greater than or equal to 25.00, the cut off point for the definition of overweight. In age-adjusted analyses, BMI was significantly and linearly associated with systolic blood pres sure, fasting glucose levels, plasma total cholesterol, VLDL cholester ol, and LDL cholesterol levels and was inversely and Linearly associat ed with HDL cholesterol levels (P<.001) in nonsmoking men and women. T he association between BMI and apolipoprotein B and A-I was similar to that of LDL and HDL cholesterol, respectively. LDL size was also line arly associated with BMI: subjects with higher BMI had smaller LDL par ticles. Lipoprotein(a) levels were not associated with BMI in this pop ulation. Of all these risk factors for CHD, reduced HDL cholesterol le vels and hypertension were those more strongly associated with higher BMI in both men and women. Elevated triglyceride levels and small LDL particles, and diabetes in women, were also strongly associated with h igher BMI values in this population. Our results indicate that a high prevalence of adult Americans are overweight and support the concept t hat increased BMI is associated with an adverse effect on all major CH D risk factors. These results emphasize the importance of excess body fat as a public health issue.