Obesity in midlife predicts stroke over coming decades

(Reuters Health).A high body mass index in middle-aged men is associated with the risk of stroke during 28 years of follow-up, even after taking into account other risk factors, such as hypertension and diabetes, Swedish investigators have found.

Obesity is increasingly accepted as a risk factor for cardiovascular disease, but its role in stroke is less clear, Dr. Katarina Jood and colleagues note in a rapid access October 28th issue of Stroke. They therefore prospectively followed men enrolled in the Multifactor Primary Prevention Study.

The 7402 apparently healthy men were between the ages of 47 and 55 at baseline in 1970. During the next 28 years, there were 873 first strokes, which included 495 ischemic strokes, 144 hemorrhagic strokes, and 234 unspecified strokes.

The mean BMI at screening was 25.5 kg/meter squared, ranging from 14.9 to 47.9, report Dr. Jood and her colleagues at Sahlgrenska University Hospital in Goteborg. Increased BMI in midlife was associated with all ischemic and unspecified strokes but not hemorrhagic stroke.

After adjusting for smoking, exercise, psychological stress, occupational class and parental history of stroke, men with a BMI > 30 had a hazard ratio of 1.93 for total stroke compared with men with BMI of 20 to 22.49. The adjusted hazard ratio was 1.78 for ischemic stroke and 3.91 for unspecified stroke.

After further adjustment for hypertension, diabetes and cholesterol level, the associations between BMI and stroke were attenuated but still remained significantly increased for those with BMI > 30.

The researchers conclude that mid-life BMI in men is a risk factor for stroke later in life. These findings underline the "importance of reducing obesity for stroke prevention."

Stroke 2004;35.

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