Heart Disease Kicks in Earlier for Obese People

Overweight and obese people tend to develop heart disease at an earlier age, living with chronic illness for much longer than those of a healthy weight, a new study shows.

People carrying excess pounds do tend to live similar or only slightly shorter life spans compared to folks with normal body weight, the researchers found.

But heart disease begins 1.8 years earlier in overweight middle-aged women compared with normal-weight women, and 4.3 years earlier for those who are obese, they added.

Meanwhile, obese middle-aged men suffer heart disease 3.1 years earlier than normal-weight men. However, overweight men tended to develop heart disease at about the same rate and live about as long as normal-weight men.

These findings show that even though some may benefit from an "obesity paradox" -- where people with excess weight live longer than those of normal weight -- those extra years of life could be filled with illness and misery, said lead researcher Dr. Sadiya Khan, an instructor at Northwestern University's Feinberg School of Medicine in Chicago.

"Individuals in the overweight category really live about the same amount of time," Khan said. "It was really the difference about how long they lived with cardiovascular disease because they developed the disease earlier in life."

For this study, Khan and her colleagues pooled together participants from 10 different research projects, coming up with a group of almost 73,000 middle-aged people with an average age of 55. All participants were healthy and free of cardiovascular disease when they enrolled in the study.

Average body mass index or BMI (a measure of body fat based on weight and height) was 27.4 for men and 27.1 for women. A BMI above 25 is considered overweight, and above 30 obese, according to the U.S. Centers for Disease Control and Prevention.

During years of follow-up, just over 13,450 people suffered a heart health event, defined as either heart failure, a stroke or a diagnosis of heart disease.

Compared to people with normal BMI, lifetime risks for developing heart disease were higher in overweight and obese adults, the researchers found.

For example, overweight middle-aged women were 32 percent more likely to develop heart disease in their lifetime compared to women of normal weight, while overweight men were 21 percent more likely to develop heart disease. Obese men and women were 67 percent and 85 percent more likely to develop heart disease, respectively.

On average, people with normal BMI also tended to enjoy more years free of heart disease.

The overweight and obese people "developed [heart disease] at a younger age and lived longer with [heart disease], with a higher risk of conditions like coronary artery disease and heart failure," Khan said.

People with excess weight likely benefit from a heart health event, in that their heart attack or stroke forces their doctor to step up their medical care, said Dr. Robert Eckel, chair of atherosclerosis at the University of Colorado Denver Anschutz Medical Campus. He was not involved with the study.

"If you're obese or overweight, your years of survival after you have a cardiovascular disease event may be a bit higher, but I think that's because these people are more aggressively treated for risk factors," said Eckel, who is also director of the Lipid Clinic at the University of Colorado Hospital.

Khan was to present the findings at the an American Heart Association meeting in Portland, Ore. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.