A new study presented at the Endocrine Society’s annual meeting, ENDO 2024, found that men under age 65 and women under age 50 who have had obesity or weight management issues for 10 years have a higher risk of developing heart disease or having a stroke. In contrast, older adults, women over 50 and men over 65, did not have an increased risk of cardiovascular disease based on overweight and obesity. Some experts suggest that the obesity paradox, which posits that extra weight may have a protective effect on older adults, could help explain this discrepancy in risk between younger and older populations.

The researchers used data from the Nurses’ Health Study and the Health Professionals Follow-Up Study to analyze health information for over 100,000 women and nearly 30,000 men with a body mass index (BMI) greater than 25. They reported a 25-60% increase in the risk of heart attack and stroke for women under 50 and men under 65 who had been obese for 10 years or more. However, there was no increased risk for women over 50 and men over 65 with a longer duration of obesity. Based on these findings, the researchers concluded that early obesity treatment is essential for maintaining cardiovascular health.

Dr. Andrew Turchin, the study’s lead author and director of quality at Brigham & Women’s Hospital, emphasized the importance of timely intervention in obesity treatment to prevent complications and improve patient outcomes. Dr. Sean Heffron, a cardiologist at NYU Langone Health, pointed out the variations in how obesity severity and duration impact different health conditions such as hypertension, type 2 diabetes, dyslipidemia, and cardiovascular issues. He suggested that the overall burden of obesity on health might vary depending on the individual’s age and duration of obesity.

The study’s findings indicate that older adults may have a lower risk of heart attack and stroke associated with obesity compared to younger individuals. This obesity paradox suggests that although overweight or obese individuals are at increased risk of heart problems, once they develop a heart condition, those with higher BMIs may be less likely to die than those with average weight. Dr. Cheng-Han Chen, an interventional cardiologist, noted that extra weight in later years can have protective benefits and may indicate robustness and better cardiovascular outcomes in older populations.

Dr. Michelle Weinberg, a cardiologist at Providence Saint John’s Health Center, emphasized the middle age group as having the highest risk due to longer exposure to obesity, while younger individuals had less disease burden and older adults experienced some protective effects of extra weight. Dr. Chen highlighted the importance of developing heart-healthy lifestyles early in life to prevent cardiovascular complications later on. Overall, the study underscores the significance of early obesity treatment in preventing heart disease and stroke risk in younger individuals and highlights the complex relationship between weight, age, and cardiovascular health.

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