Weight changes and risk of ischaemic heart disease for middle aged and elderly men. An 8-year follow-up in the Copenhagen Male study.

Abstract

Weight gain and weight loss are determined by a complex interplay of health, lifestyle and genetic factors. There is controversy concerning whether weight changes are associated with an increased risk of ischaemic heart disease (IHD). The Copenhageri Male Study was initiated in 1970/1971. This paper presents the results of a prospective study using a baseline comprising survivors examined 15 years later in 1985/1986 including 2903 men (aged 53-74 years) without cardiovascular disease. They were classified according to their weight change from 1970/1971 to 1985/1986. There were no differences among the incidences of IHD during the period 1985/1986-1993 for men who had lost weight (> 5% weight loss), men whose weight had remained constant (within +/-5%) and men who had gained weight (> 5% weight gain); the incidence rates were 7.8, 8.4 and 7.6%, respectively, NS. Adjustment for age and confounders including disease history had no influence on this result. Only for men who had already been overweight at the time of initial study in 1970/1971 (body mass index > 28 kg/m2) was there a slightly increased risk of IHD among those who gained weight. Men in this group who gained weight were characterized by a significantly (P < 0.05) larger tendency to have the Lewis phenotype Le(a-b-), a genetic marker previously shown to be associated with an increased risk of IHD mortality. With respect to death from all causes, only those who lost weight had a significantly increased risk compared with that of the constant weight group; the incidence rates were 25.0 and 12.6%, respectively, age-adjusted P < 0.001. The incidence rate of IHD among those who gained weight was 11.8%, NS. The results suggest that an increase or decrease in weight from middle age to old age is of little clinical importance in the prediction of IHD among men without cardiovascular disease.