Long‑term overweight link

Heart risk tracks years of extra weight more closely than a single body mass index reading, according to a new April 8 study in *PLOS One*. (journals.plos.org) Researchers from Mass General Brigham analyzed 136,498 adults in the Nurses’ Health Study and the Health Professionals Follow-Up Study, focusing on people whose body mass index was above 25 between 1990 and 1999. They then tracked heart attacks and strokes starting in 2000. (journals.plos.org) Instead of asking what a person weighed at one visit, the team calculated cumulative exposure to excess weight over a decade. In models that included that long-term measure, baseline body mass index in 1990 no longer predicted cardiovascular risk. (journals.plos.org) Body mass index is a height-and-weight screening tool, and a score above 25 is commonly classified as overweight. The study used that threshold to estimate how much excess body mass participants carried, and for how long. (cdc.gov) (journals.plos.org) The steepest associations showed up in younger adults. People in the highest quarter of long-term excess-weight exposure had higher cardiovascular risk for women younger than 35, women 35 to 50, men 35 to 50, and men 50 to 65. (journals.plos.org) The hazard ratios were 1.60 for women younger than 35, 1.27 for women 35 to 50, 1.57 for men 35 to 50, and 1.23 for men 50 to 65 when the highest and lowest exposure groups were compared. The study did not find a significant increase for women older than 50 or men older than 65. (journals.plos.org) The cohort’s mean baseline body mass index was 27.2, and the mean annualized cumulative excess body mass index exposure was 3.9. Participants were followed for an average of 26.7 years, and about 8.8% had a cardiovascular event, according to coverage based on the study and the research group’s release. (journals.plos.org) (beckerscardiology.com) The paper does not say excess weight is the only driver of heart disease. Smoking, blood pressure, cholesterol, diabetes, diet, physical activity, sleep, and access to care also shape cardiovascular risk, according to the United States Centers for Disease Control and Prevention. (cdc.gov) The authors called the work a secondary analysis of two long-running observational cohorts, which means it can show association but not prove that weight duration alone caused later heart attacks or strokes. The cohorts also included health professionals, not a random cross-section of the United States population. (journals.plos.org) (hsph.harvard.edu) The practical shift is in what gets measured over time: not just whether body mass index is high today, but how many years it has stayed high. That leaves clinicians and patients with a longer timeline to watch, and a longer one to change. (massgeneralbrigham.org)