Longer time being obese leads to coronary disease

Longer time being obese leads to coronary disease

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Longer time being obese leads to coronary disease
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This article highlights NIH-supported research, which found that the length of time a young adult is obese is associated with the development of silent, or subclinical, heart disease in middle age

Longer time being obese leads to coronary disease

Nanci Hellmich , USA TODAY 4:01 p.m. EDT July 16, 2013

The longer young adults are obese the greater their risk of developing hardened plaque in their arteries.

(Photo: Justin Sullivan, Getty Images)

Story Highlights

• Being obese in your 20s and 30s increases risk of heart attack and stroke later
• This is important because people are becoming obese at younger ages
• Obesity raises the risk of many diseases including type 2 diabetes

Here's another good reason for young adults to maintain a healthy weight: People who are obese for a longer time in their 20s, 30s and 40s are at an increased risk of developing hardened plaque in their arteries, which increases their risk of having a heart attack or a stroke later in life, a new study shows.
"This is important because with the obesity epidemic people are becoming obese at a younger age than in previous generations, and they are spending a longer period of their life with obesity," says the study's lead author Jared Reis, an epidemiologist in the National Heart, Lung and Blood Institute's division of cardiovascular sciences.
"This is one of the first studies to show that a longer duration of obesity independently contributes to hardened plaque in the arteries, which is sometimes called silent heart disease because there are no symptoms," he says.
Cardiologist Mariell Jessup, president of the American Heart Association, says, "If we had to target one particular group of Americans for the treatment of obesity, we certainly want to work on children and young adults. If we don't tackle obesity in these young people, there will be an epidemic of coronary artery disease just like there is currently an epidemic of obesity."
About a third of adults in this country are obese, which is roughly 35 or more pounds over a healthy weight. Experts have known for years that obesity increases the risk of many diseases including type 2 diabetes, heart disease and some types of cancer.
Reis and colleagues analyzed data from about 3,300 white and African-American adults who were followed for 25 years. Participants were ages 18 to 30 when they began the study in the mid-1980s, around the start of the U.S. obesity epidemic.
Information on the participants was collected over more than two decades including their body mass index, a number that takes into account height and weight, waist circumference, smoking habits, diet, physical activity level, cholesterol, blood pressure and their development of type 2 diabetes. Participants also had CT (computed tomography) scans at years 15, 20 and 25 to examine coronary artery calcification, also called hardened plaque.
Among the findings published today in JAMA, the Journal of the American Medical Association:
• For every year the young adults were obese, their risk of developing hardened plaque increased by 2% to 4%. This was independent of the participants' age, sex, race, socio-economic status, BMI, waist circumference, smoking, physical activity level, diet and alcohol consumption, Reis says.
• People who had the longest duration of obesity and abdominal obesity were at a greater risk of developing high blood pressure and high cholesterol; had higher rates of type 2 diabetes and were more likely to use lipid-lowering medications and high blood pressure medications.
The reason obesity duration is associated with an increased risk of calcified plaque may be because fat is "metabolically active and leads to increases in inflammation, which plays a critical role in the development and progress of atherosclerosis," Reis says.
Atherosclerosis is the term for the process of fatty substances, cholesterol, cellular waste products, calcium and fibrin (a clotting material in the blood) building up in the inner lining of an artery, according to the American Heart Association. The buildup that results is called plaque.
Jessup adds, "If there is inflammation in the lining of the coronary arteries, the body attempts to heal that area and may subsequently develop plaque as a way of healing. It's not healthy healing, but that's how it heals."
Two things that can happen where plaque occurs are: A piece of the plaque may break off or a blood clot (thrombus) may form on the plaque's surface. If either of these occurs and blocks the whole artery, a heart attack or stroke may result, the heart association says.
Atherosclerosis is a slow, progressive disease that may start in childhood, the heart association says. In some people this disease progresses rapidly in their third decade. In others it doesn't become threatening until they're in their 50s or 60s.
According to the American Heart Association, when your weight is in a healthy range:
• Your body more effectively circulates blood.
• Your fluid levels are more easily managed.
• You are less likely to develop type 2 diabetes, heart disease, certain cancers and sleep apnea.