OBJECTIVE:To examine the association between hospital-diagnosed overweight/obesity and incident cardiovascular disease (CVD) according to the time period of the overweight/obesity diagnosis.
METHODS:From Danish national health registries, we identified all residents with a first-time hospital-based overweight/obesity diagnosis code, 1977-2018 (N=195,221), and an age and sex-matched general population comparison cohort (N=1,952,210). We computed adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) using Cox regression. We adjusted for comorbidities and educational level and applied 10 years of follow-up.
RESULTS:The overall incidence rate was 10.1 (95% CI; 10.0-10.1) per 1000 person-years for the comparison cohort and 25.1 (95% CI; 24.8-25.4) per 1000 person-years for the overweight/obesity cohort, corresponding to an aHR of 2.5 (95% CI: 2.4-2.5). The aHR was elevated for all subtypes of CVD: heart failure: 3.9 (95% CI: 3.7-4.1), bradyarrhythmia: 2.9 (95% CI: 2.7-3.1), angina pectoris: 2.7 (95% CI: 2.7-2.8), atrial fibrillation or flutter: 2.6 (95% CI; 2.5-2.6), acute myocardial infarction: 2.4 (95% CI; 2.3-2.4), revascularization procedure: 2.4 (95% CI: 2.2-2.5), valvular heart disease: 1.7 (95% CI: 1.6-1.8), ischemic stroke: 1.6 (95% CI: 1.4-1.7), transient ischemic attack: 1.6 (95% CI: 1.5-1.7), and cardiovascular death: 1.6 (95% CI: 1.5-1.6). The 1-10-year aHR of any CVD associated with an overweight/obesity diagnosis decreased from 2.8 (95% CI; 2.7-2.9) in 1977-1987 to 1.8 (95% CI; 1.8-1.9) in 2008-2018.
CONCLUSION:Patients with hospital-diagnosed overweight/obesity had high rates of ischemic heart disease, heart failure, structural heart disease, arrhythmia, stroke, and death, although the strength of the association decreased in recent years.