Study shows risk for heart attack and stroke increases in people with obesity for a decade or more

People under age 50 have a greater risk for heart attack or stroke if they’ve lived with obesity for 10 years, according to industry-sponsored research being presented Saturday at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass.

“It is well established that people who have excess weight at any point in time have a greater risk of heart attacks and strokes. What was not known was whether it matters for how long someone has been exposed to excess weight,” said Alexander Turchin, M.D., M.S., Director of Quality at the Division of Endocrinology at Brigham & Women’s Hospital and associate professor of medicine at Harvard Medical School in Boston.

Turchin and his team, including researchers from Eli Lilly, conducted a comprehensive study using data from the Nurses’ Health Study (NHS) and Health Professionals Follow-Up Study (HPFS). They specifically focused on patients who had a body-mass index (BMI) greater than 25 kg/m² at least once over a 10-year period (1990–1999) to understand how their weight impacted their risk for heart attack or stroke over the next two decades (2000–2020).

The researchers analyzed data from 109,259 women and 27,239 men who had an average age of 48.6 years and a BMI of 27.2 kg/m² in 1990. Of those, 6,862 had atherosclerotic cardiovascular disease, 3,587 had type 2 diabetes, and 65,101 had a history of smoking. At follow-up in 2020, the data revealed 12,048 cardiovascular events.

“We found that among women younger than 50 and men younger than 65, having obesity over a 10-year period was associated with a 25–60% increase in the risk of heart attack and stroke—and was more important than their weight at a single point in time in 1990,” Turchin said.

However, obesity in women older than 50 and men older than 65 was not associated with an increased risk for heart attack and stroke.

These findings are important for clinicians who see younger people living with obesity, as they show that the sooner someone is treated, the better.

“Viewed as a ‘glass half full,’ these findings mean that obesity at any given point in time does not ‘seal’ one’s fate,” Turchin said. “If obesity is treated in a timely fashion, its complications can be prevented.”