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Race and Ethnicity, Obesity, Metabolic Health, and Risk of Cardiovascular Disease in Postmenopausal Women
Background It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups. Methods and Results We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting...
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| Published in: | Journal of the American Heart Association 2015-05, Vol.4 (5), p.n/a |
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| container_issue | 5 |
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| container_title | Journal of the American Heart Association |
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| creator | Schmiegelow, Michelle D. Hedlin, Haley Mackey, Rachel H. Martin, Lisa W. Vitolins, Mara Z. Stefanick, Marcia L. Perez, Marco V. Allison, Matthew Hlatky, Mark A. |
| description | Background
It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups.
Methods and Results
We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting serum lipids and serum glucose and no history of cardiovascular disease or diabetes at baseline. We categorized women by body mass index (in kg/m2) as normal weight (body mass index 18.5 to |
| doi_str_mv | 10.1161/JAHA.114.001695 |
| format | article |
| fullrecord | <record><control><sourceid>wiley_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_2263e5fa4f0a4f7487e8bc1fea7c7c67</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_2263e5fa4f0a4f7487e8bc1fea7c7c67</doaj_id><sourcerecordid>JAH3969</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4719-c74999a1377deab28c9cacd3061c7f5cac2bbcc7bbd819c9f07c9ef0fe993a963</originalsourceid><addsrcrecordid>eNqFkUFP3DAQhaOqFSDgzK3yD2DBTpw4c6m02kKXCkSFWvVoTSZj1jQbr-Is1f77JpsWwamWLL-x33y2_JLkTMkLpQp1-XW-nA9KX0ipCsjfJUep1GYGUMr3r_RhchrjkxxGkZosh4PkMM0BtNbFUeIfkFhgW4urftV68v3uXNxXHPfijnusQuNJLBmbfnW-dz74-EsEJxbY1T48Y6Rtg5347CNjZOFb8S3Efs1t2OA2YiN-hqE4ST44bCKf_l2Pkx_XV98Xy9nt_Zebxfx2RtoomJHRAIAqM6ZmrNKSgJDqTBaKjMsHnVYVkamqulRA4KQhYCcdA2QIRXac3EzcOuCT3XR-jd3OBvR2vxG6R4td76lhm6ZFxrlD7eQwjS4NlxUpx2jIUGEG1qeJtdlWa66J277D5g307UnrV_YxPFs9frAcH3M5AagLMXbsXnqVtGOIdgxxUNpOIQ4dH19f-eL_F9lg0JPht2949z_eWGdQQPYHlaOprw</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Race and Ethnicity, Obesity, Metabolic Health, and Risk of Cardiovascular Disease in Postmenopausal Women</title><source>Open Access: Wiley-Blackwell Open Access Journals</source><source>PubMed Central</source><creator>Schmiegelow, Michelle D. ; Hedlin, Haley ; Mackey, Rachel H. ; Martin, Lisa W. ; Vitolins, Mara Z. ; Stefanick, Marcia L. ; Perez, Marco V. ; Allison, Matthew ; Hlatky, Mark A.</creator><creatorcontrib>Schmiegelow, Michelle D. ; Hedlin, Haley ; Mackey, Rachel H. ; Martin, Lisa W. ; Vitolins, Mara Z. ; Stefanick, Marcia L. ; Perez, Marco V. ; Allison, Matthew ; Hlatky, Mark A.</creatorcontrib><description>Background
It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups.
Methods and Results
We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting serum lipids and serum glucose and no history of cardiovascular disease or diabetes at baseline. We categorized women by body mass index (in kg/m2) as normal weight (body mass index 18.5 to <25), overweight (body mass index 25 to <30), or obese (body mass index ≥30) and by metabolic health, defined first as the metabolic syndrome (metabolically unhealthy: ≥3 metabolic abnormalities) and second as the number of metabolic abnormalities. We used Cox proportional hazards regression to assess associations between baseline characteristics and cardiovascular risk. Over 13 years of follow‐up, 1101 women had a first cardiovascular disease event (coronary heart disease or ischemic stroke). Among black women without metabolic syndrome, overweight women had higher adjusted cardiovascular risk than normal weight women (hazard ratio [HR] 1.49), whereas among white women without metabolic syndrome, overweight women had similar risk to normal weight women (HR 0.92, interaction P=0.05). Obese black women without metabolic syndrome had higher adjusted risk (HR 1.95) than obese white women (HR 1.07; interaction P=0.02). Among women with only 2 metabolic abnormalities, cardiovascular risk was increased in black women who were overweight (HR 1.77) or obese (HR 2.17) but not in white women who were overweight (HR 0.98) or obese (HR 1.06). Overweight and obese women with ≤1 metabolic abnormality did not have increased cardiovascular risk, regardless of race or ethnicity.
Conclusions
Metabolic abnormalities appeared to convey more cardiovascular risk among black women.</description><identifier>ISSN: 2047-9980</identifier><identifier>EISSN: 2047-9980</identifier><identifier>DOI: 10.1161/JAHA.114.001695</identifier><identifier>PMID: 25994446</identifier><language>eng</language><publisher>England: John Wiley & Sons, Ltd</publisher><subject>Aged ; Body Mass Index ; cardiovascular disease ; Cardiovascular Diseases - ethnology ; Cardiovascular Diseases - etiology ; Ethnic Groups - ethnology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Metabolic Syndrome - complications ; Metabolic Syndrome - ethnology ; metabolism (metabolic syndrome) ; Middle Aged ; obesity ; Obesity - complications ; Obesity - ethnology ; Original Research ; Overweight - complications ; Overweight - ethnology ; Postmenopause - ethnology ; race/ethnicity ; Risk Factors ; Women</subject><ispartof>Journal of the American Heart Association, 2015-05, Vol.4 (5), p.n/a</ispartof><rights>2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.</rights><rights>2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4719-c74999a1377deab28c9cacd3061c7f5cac2bbcc7bbd819c9f07c9ef0fe993a963</citedby><cites>FETCH-LOGICAL-c4719-c74999a1377deab28c9cacd3061c7f5cac2bbcc7bbd819c9f07c9ef0fe993a963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599406/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599406/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11562,27924,27925,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25994446$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schmiegelow, Michelle D.</creatorcontrib><creatorcontrib>Hedlin, Haley</creatorcontrib><creatorcontrib>Mackey, Rachel H.</creatorcontrib><creatorcontrib>Martin, Lisa W.</creatorcontrib><creatorcontrib>Vitolins, Mara Z.</creatorcontrib><creatorcontrib>Stefanick, Marcia L.</creatorcontrib><creatorcontrib>Perez, Marco V.</creatorcontrib><creatorcontrib>Allison, Matthew</creatorcontrib><creatorcontrib>Hlatky, Mark A.</creatorcontrib><title>Race and Ethnicity, Obesity, Metabolic Health, and Risk of Cardiovascular Disease in Postmenopausal Women</title><title>Journal of the American Heart Association</title><addtitle>J Am Heart Assoc</addtitle><description>Background
It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups.
Methods and Results
We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting serum lipids and serum glucose and no history of cardiovascular disease or diabetes at baseline. We categorized women by body mass index (in kg/m2) as normal weight (body mass index 18.5 to <25), overweight (body mass index 25 to <30), or obese (body mass index ≥30) and by metabolic health, defined first as the metabolic syndrome (metabolically unhealthy: ≥3 metabolic abnormalities) and second as the number of metabolic abnormalities. We used Cox proportional hazards regression to assess associations between baseline characteristics and cardiovascular risk. Over 13 years of follow‐up, 1101 women had a first cardiovascular disease event (coronary heart disease or ischemic stroke). Among black women without metabolic syndrome, overweight women had higher adjusted cardiovascular risk than normal weight women (hazard ratio [HR] 1.49), whereas among white women without metabolic syndrome, overweight women had similar risk to normal weight women (HR 0.92, interaction P=0.05). Obese black women without metabolic syndrome had higher adjusted risk (HR 1.95) than obese white women (HR 1.07; interaction P=0.02). Among women with only 2 metabolic abnormalities, cardiovascular risk was increased in black women who were overweight (HR 1.77) or obese (HR 2.17) but not in white women who were overweight (HR 0.98) or obese (HR 1.06). Overweight and obese women with ≤1 metabolic abnormality did not have increased cardiovascular risk, regardless of race or ethnicity.
Conclusions
Metabolic abnormalities appeared to convey more cardiovascular risk among black women.</description><subject>Aged</subject><subject>Body Mass Index</subject><subject>cardiovascular disease</subject><subject>Cardiovascular Diseases - ethnology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Ethnic Groups - ethnology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Incidence</subject><subject>Metabolic Syndrome - complications</subject><subject>Metabolic Syndrome - ethnology</subject><subject>metabolism (metabolic syndrome)</subject><subject>Middle Aged</subject><subject>obesity</subject><subject>Obesity - complications</subject><subject>Obesity - ethnology</subject><subject>Original Research</subject><subject>Overweight - complications</subject><subject>Overweight - ethnology</subject><subject>Postmenopause - ethnology</subject><subject>race/ethnicity</subject><subject>Risk Factors</subject><subject>Women</subject><issn>2047-9980</issn><issn>2047-9980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>DOA</sourceid><recordid>eNqFkUFP3DAQhaOqFSDgzK3yD2DBTpw4c6m02kKXCkSFWvVoTSZj1jQbr-Is1f77JpsWwamWLL-x33y2_JLkTMkLpQp1-XW-nA9KX0ipCsjfJUep1GYGUMr3r_RhchrjkxxGkZosh4PkMM0BtNbFUeIfkFhgW4urftV68v3uXNxXHPfijnusQuNJLBmbfnW-dz74-EsEJxbY1T48Y6Rtg5347CNjZOFb8S3Efs1t2OA2YiN-hqE4ST44bCKf_l2Pkx_XV98Xy9nt_Zebxfx2RtoomJHRAIAqM6ZmrNKSgJDqTBaKjMsHnVYVkamqulRA4KQhYCcdA2QIRXac3EzcOuCT3XR-jd3OBvR2vxG6R4td76lhm6ZFxrlD7eQwjS4NlxUpx2jIUGEG1qeJtdlWa66J277D5g307UnrV_YxPFs9frAcH3M5AagLMXbsXnqVtGOIdgxxUNpOIQ4dH19f-eL_F9lg0JPht2949z_eWGdQQPYHlaOprw</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Schmiegelow, Michelle D.</creator><creator>Hedlin, Haley</creator><creator>Mackey, Rachel H.</creator><creator>Martin, Lisa W.</creator><creator>Vitolins, Mara Z.</creator><creator>Stefanick, Marcia L.</creator><creator>Perez, Marco V.</creator><creator>Allison, Matthew</creator><creator>Hlatky, Mark A.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>201505</creationdate><title>Race and Ethnicity, Obesity, Metabolic Health, and Risk of Cardiovascular Disease in Postmenopausal Women</title><author>Schmiegelow, Michelle D. ; Hedlin, Haley ; Mackey, Rachel H. ; Martin, Lisa W. ; Vitolins, Mara Z. ; Stefanick, Marcia L. ; Perez, Marco V. ; Allison, Matthew ; Hlatky, Mark A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4719-c74999a1377deab28c9cacd3061c7f5cac2bbcc7bbd819c9f07c9ef0fe993a963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Body Mass Index</topic><topic>cardiovascular disease</topic><topic>Cardiovascular Diseases - ethnology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Ethnic Groups - ethnology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Incidence</topic><topic>Metabolic Syndrome - complications</topic><topic>Metabolic Syndrome - ethnology</topic><topic>metabolism (metabolic syndrome)</topic><topic>Middle Aged</topic><topic>obesity</topic><topic>Obesity - complications</topic><topic>Obesity - ethnology</topic><topic>Original Research</topic><topic>Overweight - complications</topic><topic>Overweight - ethnology</topic><topic>Postmenopause - ethnology</topic><topic>race/ethnicity</topic><topic>Risk Factors</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schmiegelow, Michelle D.</creatorcontrib><creatorcontrib>Hedlin, Haley</creatorcontrib><creatorcontrib>Mackey, Rachel H.</creatorcontrib><creatorcontrib>Martin, Lisa W.</creatorcontrib><creatorcontrib>Vitolins, Mara Z.</creatorcontrib><creatorcontrib>Stefanick, Marcia L.</creatorcontrib><creatorcontrib>Perez, Marco V.</creatorcontrib><creatorcontrib>Allison, Matthew</creatorcontrib><creatorcontrib>Hlatky, Mark A.</creatorcontrib><collection>Open Access: Wiley-Blackwell Open Access Journals</collection><collection>Wiley Online Library</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of the American Heart Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schmiegelow, Michelle D.</au><au>Hedlin, Haley</au><au>Mackey, Rachel H.</au><au>Martin, Lisa W.</au><au>Vitolins, Mara Z.</au><au>Stefanick, Marcia L.</au><au>Perez, Marco V.</au><au>Allison, Matthew</au><au>Hlatky, Mark A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Race and Ethnicity, Obesity, Metabolic Health, and Risk of Cardiovascular Disease in Postmenopausal Women</atitle><jtitle>Journal of the American Heart Association</jtitle><addtitle>J Am Heart Assoc</addtitle><date>2015-05</date><risdate>2015</risdate><volume>4</volume><issue>5</issue><epage>n/a</epage><issn>2047-9980</issn><eissn>2047-9980</eissn><abstract>Background
It is unclear whether obesity unaccompanied by metabolic abnormalities is associated with increased cardiovascular disease risk across racial and ethnic subgroups.
Methods and Results
We identified 14 364 postmenopausal women from the Women's Health Initiative who had data on fasting serum lipids and serum glucose and no history of cardiovascular disease or diabetes at baseline. We categorized women by body mass index (in kg/m2) as normal weight (body mass index 18.5 to <25), overweight (body mass index 25 to <30), or obese (body mass index ≥30) and by metabolic health, defined first as the metabolic syndrome (metabolically unhealthy: ≥3 metabolic abnormalities) and second as the number of metabolic abnormalities. We used Cox proportional hazards regression to assess associations between baseline characteristics and cardiovascular risk. Over 13 years of follow‐up, 1101 women had a first cardiovascular disease event (coronary heart disease or ischemic stroke). Among black women without metabolic syndrome, overweight women had higher adjusted cardiovascular risk than normal weight women (hazard ratio [HR] 1.49), whereas among white women without metabolic syndrome, overweight women had similar risk to normal weight women (HR 0.92, interaction P=0.05). Obese black women without metabolic syndrome had higher adjusted risk (HR 1.95) than obese white women (HR 1.07; interaction P=0.02). Among women with only 2 metabolic abnormalities, cardiovascular risk was increased in black women who were overweight (HR 1.77) or obese (HR 2.17) but not in white women who were overweight (HR 0.98) or obese (HR 1.06). Overweight and obese women with ≤1 metabolic abnormality did not have increased cardiovascular risk, regardless of race or ethnicity.
Conclusions
Metabolic abnormalities appeared to convey more cardiovascular risk among black women.</abstract><cop>England</cop><pub>John Wiley & Sons, Ltd</pub><pmid>25994446</pmid><doi>10.1161/JAHA.114.001695</doi><tpages>15</tpages><oa>free_for_read</oa></addata></record> |
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| source | Open Access: Wiley-Blackwell Open Access Journals; PubMed Central |
| subjects | Aged Body Mass Index cardiovascular disease Cardiovascular Diseases - ethnology Cardiovascular Diseases - etiology Ethnic Groups - ethnology Female Follow-Up Studies Humans Incidence Metabolic Syndrome - complications Metabolic Syndrome - ethnology metabolism (metabolic syndrome) Middle Aged obesity Obesity - complications Obesity - ethnology Original Research Overweight - complications Overweight - ethnology Postmenopause - ethnology race/ethnicity Risk Factors Women |
| title | Race and Ethnicity, Obesity, Metabolic Health, and Risk of Cardiovascular Disease in Postmenopausal Women |
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