Body mass index and cardiovascular disease in the Asia-Pacific Region: An overview of 33 cohorts involving 310 000 participants

C. Ni Mhurchu; A. Rodgers; W. H. Pan; D. F. Gu; M. Woodward; V. Parag; R. Lin; D. A. Bennett; S. Vander Hoorn; F. Barzi; S. MacMahon; T. H. Lam; C. Lawes; I. Suh; H. Ueshima; A. Okayama; H. Maegawa; N. Aoki; M. Nakamura; N. Kubo; T. Yamada; Z. S. Wu; C. H. Yao; L. S. Liu; J. X. Xie; M. W. Knuiman; H. Christensen; X. G. Wu; J. Zhou; X. H. Yu; A. Tamakoshi; Z. L. Wu; L. Q. Chen; G. L. Shan; X. F. Duan; R. Norton; G. Whitlock; R. Jackson; M. Fujishima; Y. Kiyohara; H. Iwamoto; J. Woo; S. Ho; Z. Hong; M. S. Huang; B. Zhou; J. L. Fuh; Y. Kita; S. R. Choudhury; S. H. Jee; I. S. Kim; G. Giles; T. Hashimoto; K. Sakata; Y. Imai; T. Ohkubo; A. Hozawa; K. Jamrozik; M. Hobbs; R. Broadhurst; K. Nakachi; X. H. Fang; S. C. Li; Q. D. Yang; Z. M. Chen; H. Tanaka; A. Nozaki; H. Horibe; Y. Matsutani; M. Kagaya; K. Hughes; J. Lee; D. Heng; B. F. Zhou; H. Y. Zhang; K. Shimamoto; S. Saitoh; Z. Z. Li; H. Y. Zhang; Y. He; S. X. Yao

doi:10.1093/ije/dyh163

Body mass index and cardiovascular disease in the Asia-Pacific Region: An overview of 33 cohorts involving 310 000 participants

C. Ni Mhurchu, A. Rodgers, W. H. Pan, D. F. Gu, M. Woodward, V. Parag, R. Lin, D. A. Bennett, S. Vander Hoorn, F. Barzi, S. MacMahon, T. H. Lam, C. Lawes, I. Suh, H. Ueshima, A. Okayama, H. Maegawa, N. Aoki, M. Nakamura, N. KuboT. Yamada, Z. S. Wu, C. H. Yao, L. S. Liu, J. X. Xie, M. W. Knuiman, H. Christensen, X. G. Wu, J. Zhou, X. H. Yu, A. Tamakoshi, Z. L. Wu, L. Q. Chen, G. L. Shan, X. F. Duan, R. Norton, G. Whitlock, R. Jackson, M. Fujishima, Y. Kiyohara, H. Iwamoto, J. Woo, S. Ho, Z. Hong, M. S. Huang, B. Zhou, J. L. Fuh, Y. Kita, S. R. Choudhury, S. H. Jee, I. S. Kim, G. Giles, T. Hashimoto, K. Sakata, Y. Imai, T. Ohkubo, A. Hozawa, K. Jamrozik, M. Hobbs, R. Broadhurst, K. Nakachi, X. H. Fang, S. C. Li, Q. D. Yang, Z. M. Chen, H. Tanaka, A. Nozaki, H. Horibe, Y. Matsutani, M. Kagaya, K. Hughes, J. Lee, D. Heng, B. F. Zhou, H. Y. Zhang, K. Shimamoto, S. Saitoh, Z. Z. Li, H. Y. Zhang, Y. He, S. X. Yao

Research output: Contribution to journal › Article › peer-review

256 Scopus citations

Abstract

Background. Few prospective data from the Asia-Pacific region are available relating body mass index (BMI) to the risks of stroke and ischaemic heart disease (IHD). Our objective was to assess the age-, sex-, and region-specific associations of BMI with cardiovascular disease using individual participant data from prospective studies in the Asia-Pacific region. Methods. Studies were identified from literature searches, proceedings of meetings, and personal communication. All studies had at least 5000 person-years of follow-up. Hazard ratios were calculated from Cox models, stratified by sex and cohort, and adjusted for age at risk and smoking. The first 3 years of follow-up were excluded in order to reduce confounding due to disease at baseline. Results. A total of 33 cohort studies, including 310 283 participants, contributed 2 148 354 person-years of follow-up, during which 3332 stroke and 2073 IHD events were observed. There were continuous positive associations between baseline BMI and the risks of ischaemic stroke, haemorrhagic stroke, and IHD, with each 2 kg/m² lower BMI associated a 12% (95% CI: 9, 15%) lower risk of ischaemic stroke, 8% (95% CI: 4, 12%) lower risk in haemorrhagic stroke, and 11% (95% CI: 9, 13%) lower risk of IHD. The strengths of all associations were strongly age dependent, and there was no significant difference between Asian and Australasian cohorts. Conclusions. This overview provides the most reliable estimates to date of the associations between BMI and cardiovascular disease in the Asia-Pacific region, and the first direct comparisons within the region. Continuous relationships of approximately equal strength are evident in both Asian and Australasian populations. These results indicate considerable potential for cardiovascular disease reduction with population-wide lowering of BMI.

Original language	English (US)
Pages (from-to)	751-758
Number of pages	8
Journal	International journal of epidemiology
Volume	33
Issue number	4
DOIs	https://doi.org/10.1093/ije/dyh163
State	Published - Aug 2004
Externally published	Yes

Keywords

Asia
Body mass index
Cardiovascular disease
Cohort study
Obesity
Overview

ASJC Scopus subject areas

Epidemiology

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10.1093/ije/dyh163

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Ni Mhurchu, C., Rodgers, A., Pan, W. H., Gu, D. F., Woodward, M., Parag, V., Lin, R., Bennett, D. A., Vander Hoorn, S., Barzi, F., MacMahon, S., Lam, T. H., Lawes, C., Suh, I., Ueshima, H., Okayama, A., Maegawa, H., Aoki, N., Nakamura, M., ... Yao, S. X. (2004). Body mass index and cardiovascular disease in the Asia-Pacific Region: An overview of 33 cohorts involving 310 000 participants. International journal of epidemiology, 33(4), 751-758. https://doi.org/10.1093/ije/dyh163

Ni Mhurchu, C, Rodgers, A, Pan, WH, Gu, DF, Woodward, M, Parag, V, Lin, R, Bennett, DA, Vander Hoorn, S, Barzi, F, MacMahon, S, Lam, TH, Lawes, C, Suh, I, Ueshima, H, Okayama, A, Maegawa, H, Aoki, N, Nakamura, M, Kubo, N, Yamada, T, Wu, ZS, Yao, CH, Liu, LS, Xie, JX, Knuiman, MW, Christensen, H, Wu, XG, Zhou, J, Yu, XH, Tamakoshi, A, Wu, ZL, Chen, LQ, Shan, GL, Duan, XF, Norton, R, Whitlock, G, Jackson, R, Fujishima, M, Kiyohara, Y, Iwamoto, H, Woo, J, Ho, S, Hong, Z, Huang, MS, Zhou, B, Fuh, JL, Kita, Y, Choudhury, SR, Jee, SH, Kim, IS, Giles, G, Hashimoto, T, Sakata, K, Imai, Y, Ohkubo, T, Hozawa, A, Jamrozik, K, Hobbs, M, Broadhurst, R, Nakachi, K, Fang, XH, Li, SC, Yang, QD, Chen, ZM, Tanaka, H, Nozaki, A, Horibe, H, Matsutani, Y, Kagaya, M, Hughes, K, Lee, J, Heng, D, Zhou, BF, Zhang, HY, Shimamoto, K, Saitoh, S, Li, ZZ, Zhang, HY, He, Y & Yao, SX 2004, 'Body mass index and cardiovascular disease in the Asia-Pacific Region: An overview of 33 cohorts involving 310 000 participants', International journal of epidemiology, vol. 33, no. 4, pp. 751-758. https://doi.org/10.1093/ije/dyh163

@article{a7434372c13e48bcbb197dc13bb9ae59,

title = "Body mass index and cardiovascular disease in the Asia-Pacific Region: An overview of 33 cohorts involving 310 000 participants",

abstract = "Background. Few prospective data from the Asia-Pacific region are available relating body mass index (BMI) to the risks of stroke and ischaemic heart disease (IHD). Our objective was to assess the age-, sex-, and region-specific associations of BMI with cardiovascular disease using individual participant data from prospective studies in the Asia-Pacific region. Methods. Studies were identified from literature searches, proceedings of meetings, and personal communication. All studies had at least 5000 person-years of follow-up. Hazard ratios were calculated from Cox models, stratified by sex and cohort, and adjusted for age at risk and smoking. The first 3 years of follow-up were excluded in order to reduce confounding due to disease at baseline. Results. A total of 33 cohort studies, including 310 283 participants, contributed 2 148 354 person-years of follow-up, during which 3332 stroke and 2073 IHD events were observed. There were continuous positive associations between baseline BMI and the risks of ischaemic stroke, haemorrhagic stroke, and IHD, with each 2 kg/m2 lower BMI associated a 12% (95% CI: 9, 15%) lower risk of ischaemic stroke, 8% (95% CI: 4, 12%) lower risk in haemorrhagic stroke, and 11% (95% CI: 9, 13%) lower risk of IHD. The strengths of all associations were strongly age dependent, and there was no significant difference between Asian and Australasian cohorts. Conclusions. This overview provides the most reliable estimates to date of the associations between BMI and cardiovascular disease in the Asia-Pacific region, and the first direct comparisons within the region. Continuous relationships of approximately equal strength are evident in both Asian and Australasian populations. These results indicate considerable potential for cardiovascular disease reduction with population-wide lowering of BMI.",

keywords = "Asia, Body mass index, Cardiovascular disease, Cohort study, Obesity, Overview",

author = "{Ni Mhurchu}, C. and A. Rodgers and Pan, {W. H.} and Gu, {D. F.} and M. Woodward and V. Parag and R. Lin and Bennett, {D. A.} and {Vander Hoorn}, S. and F. Barzi and S. MacMahon and Lam, {T. H.} and C. Lawes and I. Suh and H. Ueshima and A. Okayama and H. Maegawa and N. Aoki and M. Nakamura and N. Kubo and T. Yamada and Wu, {Z. S.} and Yao, {C. H.} and Liu, {L. S.} and Xie, {J. X.} and Knuiman, {M. W.} and H. Christensen and Wu, {X. G.} and J. Zhou and Yu, {X. H.} and A. Tamakoshi and Wu, {Z. L.} and Chen, {L. Q.} and Shan, {G. L.} and Duan, {X. F.} and R. Norton and G. Whitlock and R. Jackson and M. Fujishima and Y. Kiyohara and H. Iwamoto and J. Woo and S. Ho and Z. Hong and Huang, {M. S.} and B. Zhou and Fuh, {J. L.} and Y. Kita and Choudhury, {S. R.} and Jee, {S. H.} and Kim, {I. S.} and G. Giles and T. Hashimoto and K. Sakata and Y. Imai and T. Ohkubo and A. Hozawa and K. Jamrozik and M. Hobbs and R. Broadhurst and K. Nakachi and Fang, {X. H.} and Li, {S. C.} and Yang, {Q. D.} and Chen, {Z. M.} and H. Tanaka and A. Nozaki and H. Horibe and Y. Matsutani and M. Kagaya and K. Hughes and J. Lee and D. Heng and Zhou, {B. F.} and Zhang, {H. Y.} and K. Shimamoto and S. Saitoh and Li, {Z. Z.} and Zhang, {H. Y.} and Y. He and Yao, {S. X.}",

note = "Funding Information: New Zealand, the National Health and the Medical Research Council of Australia, the US National Institutes of Health, and an unrestricted educational grant from Pfizer Inc. We thank Sarah Lewington and Gary Whitlock for helpful comments on an earlier version of this report, and Clarissa Gould-Thorpe for secretarial support. Cliona Ni Mhurchu and Anthony Rodgers held Research Fellowships from the National Heart Foundation of New Zealand during this project. Funding Information: The Asia Pacific Cohort Studies Collaboration has been supported by grants from the Health Research Council of",

year = "2004",

month = aug,

doi = "10.1093/ije/dyh163",

language = "English (US)",

volume = "33",

pages = "751--758",

journal = "International journal of epidemiology",

issn = "0300-5771",

publisher = "Oxford University Press",

number = "4",

}

TY - JOUR

T1 - Body mass index and cardiovascular disease in the Asia-Pacific Region

T2 - An overview of 33 cohorts involving 310 000 participants

AU - Ni Mhurchu, C.

AU - Rodgers, A.

AU - Pan, W. H.

AU - Gu, D. F.

AU - Woodward, M.

AU - Parag, V.

AU - Lin, R.

AU - Bennett, D. A.

AU - Vander Hoorn, S.

AU - Barzi, F.

AU - MacMahon, S.

AU - Lam, T. H.

AU - Lawes, C.

AU - Suh, I.

AU - Ueshima, H.

AU - Okayama, A.

AU - Maegawa, H.

AU - Aoki, N.

AU - Nakamura, M.

AU - Kubo, N.

AU - Yamada, T.

AU - Wu, Z. S.

AU - Yao, C. H.

AU - Liu, L. S.

AU - Xie, J. X.

AU - Knuiman, M. W.

AU - Christensen, H.

AU - Wu, X. G.

AU - Zhou, J.

AU - Yu, X. H.

AU - Tamakoshi, A.

AU - Wu, Z. L.

AU - Chen, L. Q.

AU - Shan, G. L.

AU - Duan, X. F.

AU - Norton, R.

AU - Whitlock, G.

AU - Jackson, R.

AU - Fujishima, M.

AU - Kiyohara, Y.

AU - Iwamoto, H.

AU - Woo, J.

AU - Ho, S.

AU - Hong, Z.

AU - Huang, M. S.

AU - Zhou, B.

AU - Fuh, J. L.

AU - Kita, Y.

AU - Choudhury, S. R.

AU - Jee, S. H.

AU - Kim, I. S.

AU - Giles, G.

AU - Hashimoto, T.

AU - Sakata, K.

AU - Imai, Y.

AU - Ohkubo, T.

AU - Hozawa, A.

AU - Jamrozik, K.

AU - Hobbs, M.

AU - Broadhurst, R.

AU - Nakachi, K.

AU - Fang, X. H.

AU - Li, S. C.

AU - Yang, Q. D.

AU - Chen, Z. M.

AU - Tanaka, H.

AU - Nozaki, A.

AU - Horibe, H.

AU - Matsutani, Y.

AU - Kagaya, M.

AU - Hughes, K.

AU - Lee, J.

AU - Heng, D.

AU - Zhou, B. F.

AU - Zhang, H. Y.

AU - Shimamoto, K.

AU - Saitoh, S.

AU - Li, Z. Z.

AU - Zhang, H. Y.

AU - He, Y.

AU - Yao, S. X.

N1 - Funding Information: New Zealand, the National Health and the Medical Research Council of Australia, the US National Institutes of Health, and an unrestricted educational grant from Pfizer Inc. We thank Sarah Lewington and Gary Whitlock for helpful comments on an earlier version of this report, and Clarissa Gould-Thorpe for secretarial support. Cliona Ni Mhurchu and Anthony Rodgers held Research Fellowships from the National Heart Foundation of New Zealand during this project. Funding Information: The Asia Pacific Cohort Studies Collaboration has been supported by grants from the Health Research Council of

PY - 2004/8

Y1 - 2004/8

N2 - Background. Few prospective data from the Asia-Pacific region are available relating body mass index (BMI) to the risks of stroke and ischaemic heart disease (IHD). Our objective was to assess the age-, sex-, and region-specific associations of BMI with cardiovascular disease using individual participant data from prospective studies in the Asia-Pacific region. Methods. Studies were identified from literature searches, proceedings of meetings, and personal communication. All studies had at least 5000 person-years of follow-up. Hazard ratios were calculated from Cox models, stratified by sex and cohort, and adjusted for age at risk and smoking. The first 3 years of follow-up were excluded in order to reduce confounding due to disease at baseline. Results. A total of 33 cohort studies, including 310 283 participants, contributed 2 148 354 person-years of follow-up, during which 3332 stroke and 2073 IHD events were observed. There were continuous positive associations between baseline BMI and the risks of ischaemic stroke, haemorrhagic stroke, and IHD, with each 2 kg/m2 lower BMI associated a 12% (95% CI: 9, 15%) lower risk of ischaemic stroke, 8% (95% CI: 4, 12%) lower risk in haemorrhagic stroke, and 11% (95% CI: 9, 13%) lower risk of IHD. The strengths of all associations were strongly age dependent, and there was no significant difference between Asian and Australasian cohorts. Conclusions. This overview provides the most reliable estimates to date of the associations between BMI and cardiovascular disease in the Asia-Pacific region, and the first direct comparisons within the region. Continuous relationships of approximately equal strength are evident in both Asian and Australasian populations. These results indicate considerable potential for cardiovascular disease reduction with population-wide lowering of BMI.

AB - Background. Few prospective data from the Asia-Pacific region are available relating body mass index (BMI) to the risks of stroke and ischaemic heart disease (IHD). Our objective was to assess the age-, sex-, and region-specific associations of BMI with cardiovascular disease using individual participant data from prospective studies in the Asia-Pacific region. Methods. Studies were identified from literature searches, proceedings of meetings, and personal communication. All studies had at least 5000 person-years of follow-up. Hazard ratios were calculated from Cox models, stratified by sex and cohort, and adjusted for age at risk and smoking. The first 3 years of follow-up were excluded in order to reduce confounding due to disease at baseline. Results. A total of 33 cohort studies, including 310 283 participants, contributed 2 148 354 person-years of follow-up, during which 3332 stroke and 2073 IHD events were observed. There were continuous positive associations between baseline BMI and the risks of ischaemic stroke, haemorrhagic stroke, and IHD, with each 2 kg/m2 lower BMI associated a 12% (95% CI: 9, 15%) lower risk of ischaemic stroke, 8% (95% CI: 4, 12%) lower risk in haemorrhagic stroke, and 11% (95% CI: 9, 13%) lower risk of IHD. The strengths of all associations were strongly age dependent, and there was no significant difference between Asian and Australasian cohorts. Conclusions. This overview provides the most reliable estimates to date of the associations between BMI and cardiovascular disease in the Asia-Pacific region, and the first direct comparisons within the region. Continuous relationships of approximately equal strength are evident in both Asian and Australasian populations. These results indicate considerable potential for cardiovascular disease reduction with population-wide lowering of BMI.

KW - Asia

KW - Body mass index

KW - Cardiovascular disease

KW - Cohort study

KW - Obesity

KW - Overview

UR - http://www.scopus.com/inward/record.url?scp=4644341787&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4644341787&partnerID=8YFLogxK

U2 - 10.1093/ije/dyh163

DO - 10.1093/ije/dyh163

M3 - Article

C2 - 15105409

AN - SCOPUS:4644341787

SN - 0300-5771

VL - 33

SP - 751

EP - 758

JO - International journal of epidemiology

JF - International journal of epidemiology

IS - 4

ER -

Body mass index and cardiovascular disease in the Asia-Pacific Region: An overview of 33 cohorts involving 310 000 participants

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