Effect of 3-Year Weight History on Blood Pressure: The Atherosclerosis Risk in Communities Study

The objective of this study was to examine the effect of weight history on blood pressure. Extant data from the Atherosclerosis Risk in Communities (ARIC) study were used to compare blood pressure in women (n = 5,675) and men (n = 4,893) with different 3-year weight histories, but similar current BMI. We used mixed models regression adjusted for ethnicity, age, education, field center, smoking, alcohol consumption, antihypertensive medications, interval length, and BMI at follow-up. We also examined associations between 3-year weight history and blood pressure within weight status categories (normal weight (≥ 18.5 to <25.0 kg/m2), overweight (≥ 25.0 to <30.0 kg/m2), and obese (≥ 30.0 kg/m2)). We found weight history affected both systolic and diastolic blood pressures. Compared to men at the same BMI who had maintained their weight, men who had experienced a 10% weight gain over the previous 3 years had systolic and diastolic blood pressures that were 2.6 and 1.9 mm Hg higher, respectively (P < 0.001 for both). Associations in women were in the same direction, but smaller at 0.9 and 0.6 mm Hg (P < 0.001). With the exception of diastolic blood pressure in normal weight women, we found no significant interactions between weight change and current weight status. In conclusion, some of the variation in blood pressure among individuals at the same BMI may be due to weight change history. Effects of 3-year weight change history appear to be stronger and more consistent in men than in women, and generally similar regardless of current weight status

Nine-Year Changes in Cardiovascular Disease Risk Factors with Weight Maintenance in the Atherosclerosis Risk in Communities Cohort

Few studies have focused on the impact of weight maintenance on cardiovascular disease risk factors or addressed whether changes differ by baseline weight status and medication usage. The authors examined these issues using 9 years of follow-up data on 3,235 men and women from the Atherosclerosis Risk in Communities (ARIC) Study who were aged 45–64 years at baseline (1987–1989). In participants not using medications, glucose (3.0 mg/dl, 95% confidence interval (CI): 2.4, 3.5) and triglycerides (10.1 mg/dl, 95% CI: 8.3, 11.9) increased, while total cholesterol (−9.6 mg/dl, 95% CI: −10.6, −8.6), low density lipoprotein cholesterol (−9.9 mg/dl, 95% CI: −10.9, −9.0), and high density lipoprotein cholesterol (−1.7 mg/dl, 95% CI: −2.1, −1.3) decreased. Systolic blood pressure (7.9 mmHg, 95% CI: 7.3, 8.4) increased, but diastolic blood pressure (−1.1 mmHg, 95% CI: −1.4, −0.7) declined. Normal weight (body mass index: 18.5–<25.0 kg/m2) participants had smaller increases in glucose compared with obese (body mass index: ≥30.0 kg/m2) participants. In contrast, the authors found less favorable changes in total, low density lipoprotein, and high density lipoprotein cholesterol, triglycerides, and diastolic blood pressure among normal weight compared with obese participants who maintained their weight. These patterns were similar across weight status groups regardless of medication usage

The effect of weight history on glucose and lipids: The atherosclerosis risk in communities study

Few studies have examined the impact of weight history. Extant data from the Atherosclerosis Risk in Communities Study were used to compare risk factors for normal-weight (body mass index: 18.5–24.9 kg/m2) adults with a history of weight loss (n = 775) with those for persons with a history of weight maintenance (n = 5,164). In this 1987–1998 US study, the authors also compared risk factors for preobese (body mass index: 25.0–29.9 kg/m2) adults with a history of weight gain (n = 1,296) versus weight maintenance (n = 6,721). They used mixed-models regression to adjust for ethnicity, gender, age, education, field center, smoking, alcohol consumption, follow-up time, and follow-up body mass index. Compared with adults with a history of weight maintenance, adults with a 3-year history of weight loss had more favorable total and low density lipoprotein cholesterol levels and similar glucose, high density lipoprotein cholesterol, and triglyceride levels. In contrast, preobese adults with a 3-year history of weight gain had equivalent glucose and lipid levels at follow-up compared with adults with a history of weight maintenance. These findings suggest that, in addition to current weight, weight history may impact glucose and lipid levels

Impact of body mass index levels on lipid abnormalities in Chinese Asians, American Blacks and American Whites: The People's Republic of China (PRC) and Atherosclerosis Risk in Communities (ARIC) Studies

Several researchers have reported that Chinese adults may have a greater chronic disease burden than Whites, especially at lower body mass index (BMI) levels

Comparison of Eight Equations That Predict Percent Body Fat Using Skinfolds in American Youth

Background: Skinfolds are often used in equations to predict percent body fat (PBF) in youth. Although there are numerous such equations published, there is limited information to help researchers determine which equation to use for their sample

Impact of Body Mass Index on Incident Hypertension and Diabetes in Chinese Asians, American Whites, and American Blacks: The People's Republic of China Study and the Atherosclerosis Risk in Communities Study

Researchers have hypothesized that the impact of body mass index on chronic disease may be greater in Asians than in Whites; however, most studies are cross-sectional and have no White comparison group. The authors compared the associations with body mass index in Chinese Asians (n = 5,980), American Whites (n = 10,776), and American Blacks (n = 3,582) using prospective data from the People’s Republic of China Study (1983–1994) and the Atherosclerosis Risk in Communities Study (1987–1998). Slopes of risk differences over body mass index levels were compared among the three ethnic groups in adjusted analyses. The authors found larger associations with body mass index in Chinese Asians compared with American Whites and Blacks for hypertension (p < 0.05). The increase in the incidence of hypertension associated with a one-unit increase in body mass index over approximately 8 years of follow-up was 2.5, 1.7, and 1.8 percentage points for Chinese Asians, American Whites, and American Blacks, respectively. For diabetes, the estimates were 1.7, 1.1, and 1.6 percentage points for the same groups— higher in Chinese Asians than in American Whites (p < 0.05) but similar between Chinese Asians and American Blacks. Given the ethnic differences in associations, the results support advocacy of public health and medical actions toward obesity prevention and treatment in China

Long- and Short-term Weight Change and Incident Coronary Heart Disease and Ischemic Stroke: The Atherosclerosis Risk in Communities Study

Weight gain increases the prevalence of obesity, a risk factor for cardiovascular disease. Nevertheless, unintentional weight loss can be a harbinger of health problems. The Atherosclerosis Risk in Communities Study (1987–2009) included 15,792 US adults aged 45–64 years at baseline and was used to compare associations of long-term (30 years) and short-term (3 years) weight change with the risks of coronary heart disease (CHD) and ischemic stroke. Age-, gender-, and race-standardized incidence rates were 4.9 (95% confidence interval (CI): 4.6, 5.2) per 1,000 person-years for CHD and 2.5 (95% CI: 2.3, 2.8) per 1,000 person-years for stroke. After controlling for baseline body mass index and other covariates, long-term weight gain (since age 25 years) of more than 2.7% was associated with elevated CHD risk, and any long-term weight gain was associated with increased stroke risk. Among middle-aged adults, short-term (3-year) weight loss of more than 3% was associated with elevated immediate CHD risk (hazard ratio = 1.46, 95% CI: 1.18, 1.81) and stroke risk (hazard ratio = 1.45, 95% CI: 1.10, 1.92). Risk tended to be larger in adults whose weight loss did not occur through dieting. Avoidance of weight gain between early and middle adulthood can reduce risks of CHD and stroke, but short-term, unintentional weight loss in middle adulthood may be an indicator of immediate elevated risk that has not previously been well recognized

Body Mass Index at Age 25 and All-Cause Mortality in Whites and African Americans: The Atherosclerosis Risk in Communities Study

Approximately 20% of young adults in the United States are obese, and most gain weight between young and middle adulthood. Few studies have examined the association between elevated BMI in early adulthood and mortality or examined such effects independent of changes in weight. We know of no studies in African American samples

Obesity and Vital Exhaustion: Analysis of the Atherosclerosis Risk in the Communities Study

This study aimed to determine whether vital exhaustion (VE) was associated with BMI cross-sectionally and after 3 and 6 years of follow-up. Extant data from the Atherosclerosis Risk in Communities (ARIC) study were used to examine the relationship between VE and BMI among 13,727 white and African-American adults cross-sectionally (baseline) and longitudinally (3 and 6 years later). We used adjusted and nonadjusted general linear regression models. Associations with excess weight gain (≥5.0%) were also examined using logistic regression. Results showed that BMI was significantly higher among both white and African-American men and women in the highest VE quartile compared to those with no VE. Similarly, high VE at baseline was associated with higher BMI 3 and 6 years later, although VE was not able to predict future BMI after adjusting for baseline BMI. Baseline VE predicted future excess weight gain in white men and women, but not in African Americans. These results suggest that reducing VE levels may play an important role in reducing the prevalence of obesity. High VE was associated with higher current BMI (all races) and excess weight gain (whites only). Although high VE predicted future weight gain without baseline BMI adjustment, the magnitude of change in BMI over time was similar among those with low and high VE; suggesting that any relationship between VE and BMI was already established at baseline. Assessment of VE and BMI over time would help to elucidate uncertainties between the temporal nature of the relationship between them

Interactions Between Obesity, Parental History of Hypertension, and Age on Prevalent Hypertension: The People’s Republic of China Study

Age, family history, and body mass index (BMI) influence the prevalence of hypertension, but very little is known about the interplay of these factors in Chinese populations. The authors examined this issue in Chinese adults (n = 4104) in the People’s Republic of China Study. In young adults (24–39 years), the prevalence of hypertension/1000 persons (95% confidence interval [CI]) at the referent BMI was greater among subjects with a parental history of hypertension (35; 15–54) compared with those without (7; 3–11). Among middle-aged (40–71 years) adults, the prevalence of hypertension was similar regardless of parental history; however, the effect of BMI was modified by parental history status. For example, at BMI = 25 kg/m2, the prevalence difference/1000 persons was 375 (95% CI = 245–506) and 97 (95% CI = 51–144) among subjects with and without a parental history, respectively. These large differences call for further investigation of the genetic and environmental factors that could be driving this interaction