Abstract 12888: Risk of Sudden Cardiac Death and Coronary Heart Disease Mortality in Postmenopausal Women With History of Weight Cycling

Abstract

Introduction: Elevated midlife body mass index (BMI) is associated with sudden cardiac death (SCD) and coronary heart disease (CHD) mortality. However, it is not known whether weight cycling across adulthood increases risk of SCD and CHD mortality. Hypotheses: Weight cycling will be associated with risk of SCD and CHD mortality. This association will vary by baseline BMI. Methods: Prospective cohort study of 158,063 post-menopausal women from the Women’s Health Initiative (WHI). Self-reported weight history during adulthood was categorized as stable weight, steady gain, maintained weight loss, and weight cycling. SCD was defined as a sudden loss of consciousness within one hour of the onset of symptoms with a documented loss of pulse in a previously stable individual without evidence of non-cardiac cause of the arrest. CHD mortality was determined by physician-adjudicated review of medical record reviews. Cox proportional hazard models estimated age- and multivariate-adjusted hazards ratios (HRs) and 95% confidence intervals (CIs). Results: Over 11.4 years of follow-up (1,798,063 person-years), 2526 CHD deaths occurred and 83 SCDs were adjudicated by strict criterion. Compared to stable weight, weight cycling was associated with greater risk of SCD and CHD mortality among women who were normal weight at WHI enrollment (HR=3.44 95% CI: 1.25-9.45 for SCD; HR=1.66, 95% CI: 1.38-2.01 for CHD mortality). Weight cycling was not associated with SCD or CHD mortality among overweight or obese women (Table). Neither steady weight gain nor weight loss were associated with risk of SCD or CHD mortality (Table). Conclusions: Weight cycling during adulthood in post-menopausal women may increase the risk of SCD as well as CHD mortality. This association appears strongest in normal BMI women.