Influence of calendar period on the association between BMI and coronary heart disease: A meta‐analysis of 31 cohorts |
| |
| Authors: | Ellen L. de Hollander Rik P. Bogers Hendriek C. Boshuizen Annika Rosengren Martin J. Shipley Paul Knekt Pierre Ducimetière Alessandro Menotti Lisette CPGM de Groot Wanda J.E. Bemelmans for the BMI‐CHD collaboration investigators |
| |
| Affiliation: | 1. Center for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands;2. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands;3. Center for Information Technology and Methodology Consultancy, National Institute of Public Health and the Environment, Bilthoven, The Netherlands;4. Department of Medicine, Sahlgrenska University Hospital/?stra, G?teborg, Sweden;5. Department of Epidemiology and Public Health, University College London, London, UK;6. Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland;7. Institut National de la Sant et de la Recherche Médicale (INSERM), Unit 258, Cardiovascular and Metabolic Epidemiology, Villejuif, France;8. Association for Cardiac Research, Rome, Italy |
| |
| Abstract: | Objective: The association between obesity and coronary heart disease (CHD) may have changed over time, for example due to improved pharmacological treatment of CHD risk factors. This meta‐analysis of 31 prospective cohort studies explores the influence of calendar period on CHD risk associated with body mass index (BMI). Design and Methods: The relative risks (RRs) of CHD for a five‐BMI‐unit increment and BMI categories were pooled by means of random effects models. Meta‐regression analysis was used to examine the influence of calendar period (>1985 v ≤1985) in univariate and multivariate analyses (including mean population age as a covariate). Results: The age, sex, and smoking adjusted RR (95% confidence intervals) of CHD for a five‐BMI‐unit increment was 1.28(1.22:1.34). For underweight, overweight and obesity, the RRs (compared to normal weight) were 1.11(0.91:1.36), 1.31(1.22:1.41), and 1.78(1.55:2.04), respectively. The univariate analysis indicated 31% (95%CI: ?56:0) lower RR of CHD associated with a five‐BMI‐unit increment and a 51% (95%CI: ?78: ?14)) lower RR associated with obesity in studies starting after 1985 (n = 15 and 10, respectively) compared to studies starting in or before 1985 (n = 16 and 10). However, in the multivariate analysis, only mean population age was independently associated with the RRs for a five‐BMI‐unit increment and obesity (?29(95%CI: ?55: ?5)) and ?31(95%CI: ?66:3), respectively) per 10‐year increment in mean age). Conclusion: This study provides no consistent evidence for a difference in the association between BMI and CHD by calendar period. The mean population age seems to be the most important factor that modifies the association between the risk of CHD and BMI, in which the RR decreases with increasing age. |
| |
| Keywords: | |
|
|
