Cardiac Risk Factors May Improve in Obese Weight Maintainers

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NEW YORK (Reuters Health) Apr 10 - The cardiovascular risk profile may improve somewhat in obese subjects who maintain their weight over the years, researchers from the University of North Carolina School of Public Health, Chapel Hill have observed.

"Although the public health message remains that obesity and excess weight gain should be avoided in order to reduce cardiovascular risk, it is useful to know that changes in cardiovascular disease risk factors are not necessarily more favorable in normal weight compared with obese adults who maintain their weight," Kimberly P. Truesdale and colleagues write in the April 15 American Journal of Epidemiology.

The investigators analyzed changes in cardiovascular disease risk factors among 3,235 men and women who maintained their weight over 9 years in the Atherosclerosis Risk in Communities (ARIC) study. At baseline, 35% of weight maintainers were normal weight, 41% were overweight, and 23% were obese.

For the group as a whole, in the absence of medication, with 9 years of aging and weight maintenance, the team observed an increase in glucose (3.0 mg/dL) and triglycerides (10.1 mg/dL) and a decrease in total cholesterol (-9.6 mg/dL), LDL-cholesterol (-9.9 mg/dL) and HDL-cholesterol (-1.7 mg/dL). Systolic BP increased (7.9 mm Hg) but diastolic BP decreased (-1.1 mm Hg).

By weight category, normal weight subjects had smaller increases in glucose compared with obese subjects. In contrast, the researchers found "less favorable" changes in total, LDL, and HDL cholesterol, triglycerides, and diastolic BP in normal weight subjects compared with obese subjects who maintained their weight over the 9 years.

In summary, the investigators write, "Obese adults who maintained their weight had long-term changes in risk factors that were the same or more favorable than changes in normal weight adults for lipid levels and blood pressure." This was not due to differences in the use of medications.

"Nevertheless, it is important to keep in mind," they emphasize, "that the absolute levels of cardiovascular disease risk factors were less favorable among obese compared with normal weight subjects."

Am J Epidemiol 2007;165:890-900.