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Reviewed By Louise Chang, MD
Wake Forest University researcher Gregory L. Burke, MD, and colleagues studied nearly 7,000 people enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) trial who were free of heart disease at the beginning of the study.
Trial participants underwent intensive investigation of their heart disease risk. The researchers evaluated patients for the presence of traditional risk factors such as weight, high LDL cholesterol levels, high blood pressure, and diabetes. They also looked for signs of subclinical heart disease, such as calcium buildup in heart arteries, narrowing of the carotid arteries, and increased heart muscle mass.
The findings bring little good news, except for Chinese-American participants, only 33% of whom were overweight and only 5% of whom were obese. Study participants from other ethnic groups fared poorly:
- 60% to 85% of white, African-American, and Hispanic participants were overweight.
- 30% to 40% of white and Hispanic participants were obese; this also held true for African- American men
- More than 50% of African-American women were obese.
Because the study left out people who already had heart disease, Burke and colleagues suggest their figures underestimate the true prevalence of obesity.
Even though they took more medications for high blood pressure, high cholesterol, and high blood sugar, obese study participants had higher blood pressure and blood sugar levels and more abnormal cholesterol profiles than did normal-weight participants.
But the most disturbing study finding was that when compared to normal-weight people who had the same traditional risk factors for heart disease, obese people had more advanced signs of subclinical heart disease. Obese individuals displayed higher rates of calcium buildup in their heart arteries, more narrowing of their carotid arteries, and higher measurements of heart muscle mass. All of these indicators suggest a higher risk of cardiac events in the future.
"Our findings support the imperative to redouble our efforts to assist in increasing healthy behaviors and to remove environmental barriers to maintaining a healthy weight," Burke and colleagues conclude.
Their report appears in the May 12 issue of Archives of Internal Medicine.
SOURCES: Burke, G.L. Archives of Internal Medicine, May 12, 2008; vol 168: pp 928-935.
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