Obesity and overweight in relation to disease-specific mortality in men with and without existing coronary heart disease in London: the original Whitehall study

Heart. 2006 Jul;92(7):886-92. doi: 10.1136/hrt.2005.072637. Epub 2005 Nov 3.

Abstract

Objective: To examine the relations between obesity or overweight and coronary heart disease (CHD) mortality in men with and without prevalent CHD in a prospective cohort study.

Methods: In the Whitehall study of London-based male government employees, 18 403 middle age men were followed up for a maximum of 35 years having participated in a medical examination in the late 1960s in which weight, height, CHD status, and a range of other social, physiological, and behavioural characteristics were measured.

Results: In age-adjusted analyses of men with baseline CHD there was a modest raised risk in the overweight relative to normal weight groups for all cause mortality (hazard ratio 1.10, 95% confidence interval (CI) 1.00 to 1.20) and CHD mortality (1.28, 95% CI 1.11 to 1.47) but not for stroke mortality (1.01, 95% CI 0.73 to 1.40). Mortality was similarly raised in the obese group. While these slopes were much steeper in men who were apparently CHD-free at study induction, the difference in the gradients according to baseline CHD status did not attain significance at conventional levels (p value for interaction >or= 0.24). The weight-mortality relations were somewhat attenuated when potential mediating and confounding factors were added to the multivariable models in both men with and men without a history of CHD.

Conclusions: Avoidance of obesity and overweight in adult life in men with and without CHD may reduce their later risk of total and CHD mortality.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cause of Death
  • Coronary Disease / complications
  • Coronary Disease / mortality*
  • Humans
  • London / epidemiology
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / mortality*
  • Overweight / physiology*
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors