For the Obese, Heart Attacks Come Earlier
Finding challenges belief that extra weight offers protection

(HealthDay News) -- As numbers on the scale climb, so does the likelihood that the person getting weighed will have a heart attack at a young age.

That's partly because obese people are more apt to have other risk factors for heart disease, such as diabetes, high cholesterol and high blood pressure. But even with those factors taken into account, being overweight itself adds considerable risk, according to Dr. Eric D. Peterson, a professor of medicine at the Duke University Medical Center.

He took part in a study that examined data on more than 111,000 people who had heart attacks. The researchers focused on body mass index (BMI), an indicator of body fatness calculated from a person's weight and height. People with a BMI of 30 or more are considered obese.

Peterson and his fellow researchers found that the higher the BMI, the younger people were at the time of their first heart attack. People with a BMI of 18.5 or less had first heart attacks, on average, at about 75 years old; a BMI of 25-30 correlated to a heart attack at age 71; for a BMI of 30-35, the age was 68; for a BMI of 35-40, it was 61; and first heart attacks occurred at 59 years of age, on average, for those with a BMI of 40 or higher.

"That is a pretty profound difference," Peterson told HealthDay. The findings were published in the Journal of the American College of Cardiology.

New insight into how obesity increases cardiac risk was provided in another study in the same issue of the journal. Researchers in the Netherlands, who had obese people with diabetes go on long-term diets, found that in addition to a reduction in BMI, the participants were better able to manage blood sugar levels and their heart muscle cells showed improvement.

"The news here is that heart muscle in obese diabetic individuals can be mobilized by eating less," Dr. Heinrich Taegtmeyer, a professor of medicine in cardiology at the University of Texas Health Sciences Center in Houston, told HealthDay.

He added that the mechanism by which dieting benefits heart cells "is only vaguely understood." It's believed that dieting, or caloric restriction, activates an enzyme that prevents fat from being deposited in heart cells.

Both Taegtmeyer and Peterson mentioned that animal studies have shown that strict caloric restriction lengthens life.

"It has been shown in virtually every organism, from yeast to flies to worms to mammals, that caloric restriction heightens life expectancy," Taegtmeyer said. "The heart functions better with caloric restriction."

Peterson noted that some obese people take comfort from studies showing that they're more likely to survive a heart attack than thinner people. But his study indicates that the reason is because fat people have heart attacks at a younger age, when they're otherwise sturdier physically.

"If you had your choice, you would choose not to have a heart attack in the first place," Peterson said.

On the Web

To learn more about preventing heart disease, heart attack and stroke, visit the American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=3035374

SOURCES: HealthDay News ; Eric D. Peterson, M.D., M.P.H., professor of medicine, Division of Cardiology, Duke University Medical Center, Durham, N.C.; Heinrich Taegtmeyer, M.D., professor of medicine, University of Texas Health Sciences Center, Houston; Sept. 16, 2008, Journal of the American College of Cardiology
Author: Robert Preidt
Publication Date: Sept. 30, 2009
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