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Author (up) Morkedal, B.; Vatten, L.J.; Romundstad, P.R.; Laugsand, L.E.; Janszky, I.   
  Title Risk of myocardial infarction and heart failure among metabolically healthy but obese individuals: HUNT (Nord-Trondelag Health Study), Norway Type Journal Article
  Year 2014 Publication J Am Coll Cardiol Abbreviated Journal Journal of the American College of Cardiology  
  Volume 63 Issue 11 Pages 1071-1078  
  Keywords HUNT2; Adult; Age Factors; Aged; *Body Mass Index; Case-Control Studies; *Cause of Death; Female; Heart Failure/*etiology/mortality/physiopathology; Humans; Male; Metabolic Syndrome X; Middle Aged; Myocardial Infarction/*etiology/mortality/physiopathology; Obesity/*complications/diagnosis/metabolism; Obesity, Morbid/complications/diagnosis; Prognosis; Prospective Studies; Risk Assessment; Severity of Illness Index; Sex Factors; Survival Rate; Time Factors  
  Abstract OBJECTIVES: This study sought to investigate whether obesity in the absence of metabolic abnormalities might be a relatively benign condition in relation to acute myocardial infarction (AMI) and heart failure (HF). BACKGROUND: The results of previous studies are conflicting for AMI and largely unknown for HF, and the role of the duration of obesity has not been investigated. METHODS: In a population-based prospective cohort study, a total of 61,299 men and women free of cardiovascular disease were classified according to body mass index (BMI) and metabolic status at baseline. BMI also was measured 10 and 30 years before baseline for 27,196 participants. RESULTS: During 12 years of follow-up, 2,547 participants had a first AMI, and 1,201 participants had a first HF. Compared with being normal weight (BMI <25 kg/m(2)) and metabolically healthy, the multivariable-adjusted hazard ratio (HR) for AMI was 1.1 (95% confidence interval [CI]: 0.9 to 1.4) among obese (BMI >/=30 kg/m(2)) and metabolically healthy participants and 2.0 (95% CI: 1.7 to 2.3) among obese and metabolically unhealthy participants. We found similar results for severe (BMI >/=35 kg/m(2)), long-lasting (>30 years), and abdominal obesity stratified for metabolic status. For HF, the HRs associated with obesity were 1.7 (95% CI: 1.3 to 2.3) and 1.7 (95% CI: 1.4 to 2.2) for metabolically healthy and unhealthy participants, respectively. Severe and long-lasting obesity were particularly harmful in relation to HF, regardless of metabolic status. CONCLUSIONS: In relation to AMI, obesity without metabolic abnormalities did not confer substantial excess risk, not even for severe or long-lasting obesity. For HF, even metabolically healthy obesity was associated with increased risk, particularly for long-lasting or severe obesity.  
  Corporate Author Thesis  
  Publisher Place of Publication Department of Public Health and General Practice, Norwegian University of Science and Technology, Tr Editor  
  Language Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN ISBN Medium  
  Area Expedition Conference  
  Notes Approved no  
  Call Number HUNT @ maria.stuifbergen @ Morkedal2014 Serial 1610  
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