Long‐ and short‐term weight change and incident coronary heart disease: The Atherosclerosis Risk in Communities Study

Abstract

Associations between weight change and coronary heart disease (CHD) have been inconsistent possibly due to differences in length of weight change or follow-up studied. Short-term (ST) decreases in weight close to an event could be unintentional and due to underlying disease, while long-term (LT) increases in adult weight might cause CHD. We examined associations of LT and ST weight change on incident CHD using extant data from 15,689 African Americans and Whites 45–64 years at baseline (1987–89), who were followed through 2005. LT weight change, measured weight at baseline minus recalled weight at age 25, was analyzed excluding events within 3 years after baseline. The effect of ST weight change between two successive visits on CHD events in the subsequent interval was examined using a time-dependent covariate approach. Multivariable adjusted Cox regression was used for analysis. As hypothesized, ST weight loss (>3% of weight) was associated with elevated CHD risk (RR 1.46; 95% CI: 1.18, 1.81) compared to weight maintenance (±3%), however, contrary to our hypothesis LT weight loss was also associated with incident CHD (RR 1.31; 95% CI: 1.00, 1.73). As predicted LT weight gain elevated CHD risk (RR for ≥ 30% gain 1.38; 95% CI: 1.08, 1.76) and ST weight gain was not associated with increased risk. This work illustrates the complex nature of the relationship between the timing of changes in weight and CHD events. Grant Funding Source: National Heart, Lung and Blood Institute [grant number 1RC1HL099429]