Being Overweight And Obesity Increase Risk For Heart Attack

Does the amount of body fat increase one’s risk for heart disease and heart attack?

Adiposity or body fat is usually measured in terms of body mass index (BMI), which is expressed in weight with reference to one’s height.

Researchers from the University Medical Center Groningen, in the Netherlands, reported in 2010 that certain obese people are not at high risk for heart disease or diabetes. Their study found that in more than 1,300 of the obese patients who took part their study, about seven percent were “metabolically healthy,” which meant that these individuals did not have any history of heart disease, stroke, diabetes, high blood pressure, or dyslipidemia (high blood cholesterol and triglyceride levels).

Among this group of patients, only one eventually developed heart disease after more than seven years of follow-up. Statistical analysis showed that this low percentage was not significant, or that it was similar to the incidence of heart disease among people of normal weight or overweight.

Another review of 97 studies involving close to three million people all around the world also questioned whether being overweight alone — without metabolic syndrome or other risk factors — is a risk factor for premature death. 

BMI and Metabolic Syndrome

The authors of the 2010 study warned that only a small subset of the obese participants in their research was obese but healthy, and that they were still at risk for other obesity-related conditions, such as arthritis.

Obesity is a chronic disease that plagues about 78 million Americans today, who spend about $150 billion annually on obesity-related complications. Many overweight and obese individuals also have other conditions that increase their risk for heart disease and heart attack, including high blood cholesterol and triglyceride levels, excess belly fat, high blood pressure, and high blood sugar levels or diabetes. 

In fact, researchers from the Copenhagen University Hospital and the University of Copenhagen in Denmark who examined more than 70,000 people over the course of a few years, found in 2013 that metabolic syndrome was present in only 62 percent of the obese participants, in 40 percent of the overweight and in 10 percent of normal-weight subjects.

New Study Confirms Role Of BMI In Heart Attack Risk

Contrary to previous studies, the Danish report showed that overweight and obese individuals are at increased risk for ischemic heart disease and heart attack, whether or not they have metabolic syndrome. 

Read More: Heart Attack Risks That Might Surprise You

After following up on the participants for almost four years, the study team found that overweight participants had a 38 percent higher risk of suffering from a heart attack and a 25 percent increased likelihood of developing heart disease than those who had a normal and healthy BMI.

These key findings suggest that the absence of metabolic disease in overweight or obese people does not eliminate their risk for cardiovascular disease and its complications. Expert opinion published in the same journal (JAMA Internal Medicine) states that overweight and obesity are closely connected with different components of the metabolic syndrome. This they found, after observing that participants who were either obese or overweight tended to have worse laboratory results for some risk factors, such as high blood pressure, than normal-weight participants.

Obese but Healthy: Is it Possible?

Can obese people be really healthy? A recent study published by French scientists in Diabetes Care showed that “healthy obesity" is a temporary state. During their 17 years follow-up of adults ages 39-62 years, they found that about one-third of obese participants develop metabolic syndrome within 5 to 10 years. They also found that compared with normal-weight individuals who were metabolically healthy, both obese people who were metabolically healthy and those who were metabolically abnormal had an increased risk of premature death related to cardiovascular disease.

Lessons Learned

People do not have to look much into statistics to know if their body weight is doing any good for their overall health. Although some people feel healthy with a few excess pounds or inches here and there, it is best to keep in mind that it may just be a matter of time before symptoms of high blood pressure or high blood sugar levels become apparent. You do not have to wait for these risk factors to manifest, whether you are overweight or obese, to start trying to lose the belly fat that could later lead to heart disease. Experts recommend living a healthy lifestyle that includes a balanced diet and engaging in some form of exercise to maintain a healthy body weight.

Chandra Jackson, a postdoctoral research fellow in the Department of Nutrition at Harvard University in Boston, wrote the journal’s editorial, saying that the study provides evidence that preventing weight gain and maintaining a healthy weight should be a priority for health.

It is also important to remember that losing weight should not be the only concern of both patient and doctor. Copenhagen University Hospital Professor Nordestgaard says that if metabolic syndrome is present, doctors must treat individual risk factors rather than treat the metabolic syndrome per se, since risk factor management is evidence-based.