Healthgrades for Professionals

Empowering physicians with a patient perspective

Risk for heart attack and stroke higher in younger adults who have had obesity for a decade or more

The shadow of a person leaning on a rail
Researchers say the risk to heart health from obesity is greater in younger adults than older adults. aykut karahan/Getty Images
  • 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, according to a new study.
  • Researchers reported that older adults – women over 50 and men over 65 – did not have an increased risk based on overweight and obesity.
  • Some experts say the obesity paradox – the idea that the extra weight has a protective effect on older adults – can help explain why there was not an increased risk of cardiovascular disease in the older population.

Men younger than age 65 and women under age 50 who are overweight or have had obesity for 10 years have a greater risk of heart attack and stroke, according to a new study presented at the Endocrine Society’s annual meeting, ENDO 2024.

For their findings, which haven’t been published yet in a peer-reviewed journal, researchers used data from the Nurses’ Health Study and the Health Professionals Follow-Up Study.

They analyzed health information for 109,259 women and 27,239 men with a body mass index (BMI) greater than 25. They also looked at heart attack and stroke records between 2000 and 2020. During the study period, there were 12,048 cardiovascular events.

For women under 50 and men under 65 with obesity for 10 years or more, the researchers reported that:

  • There was a 25% to 60% increase in the risk of heart attack and stroke.
  • For women older than 50 and men older than 65, there was not an increased risk.

Based on their findings, the researchers concluded that the earlier someone receives obesity treatment, the better their cardiovascular health.

“Excess weight brings about its harmful effects when it’s present for a long time,” Dr. Andrew Turchin, the study’s lead author and the director of quality at the Division of Endocrinology at Brigham & Women’s Hospital as well as an associate professor of medicine at Harvard Medical School in Boston, told Medical News Today. “Preventing that – by treating obesity early on – could prevent complications and improve patient outcomes. This information shows medical professionals that timely intervention is key for the prevention of complications of obesity. Now that there are more and more options to help individuals with overweight and obesity lose weight, medical professionals should lose no time making these treatments available to their patients.”

Obesity and overall health

Dr. Sean Heffron, a cardiologist at NYU Langone Health in New York, studies the relationship between heart health and obesity.

“This is a topic that is very important and one I am currently investigating,” Heffron, who wasn’t involved in the research, told Medical News Today. “Without reading the full study, it is difficult to give definite conclusions. However, it might be that in cases where the overall burden of obesity is less, the people were overall healthier and became older without other medical conditions.”

In a review article Trusted Source AHA/ASA Journals Peer reviewed journal Go to source published in 2023, Heffron and his colleagues described how obesity severity as well as duration impacted health conditions differently.

He detailed conditions and the effects obesity has on them:

  • Hypertension – obesity severity has a more significant influence than duration
  • Type 2 diabetes – obesity duration has a more substantial influence than severity
  • Dyslipidemia – obesity severity has a more significant influence than duration
  • Cardiovascular, all-cause mortality, ASCVD, and cardiomyopathy – duration and severity are important

“This [new] study looked at how obesity impacted different age groups,” Dr. Nicole Weinberg, a cardiologist at Providence Saint John’s Health Center in California who was not involved in the research, told Medical News Today. “The middle group had the highest risk. The younger group had less of a disease burden because of the shorter duration of obesity. The older group saw some protective benefits of extra weight. The middle group drives home how a higher BMI can negatively impact health.”

Obesity in older age

The findings of the new study indicate that for older adults, the risk of heart attack and stroke associated with obesity is less than it is with younger people.

This obesity paradox relates to counter-intuitive findings suggesting that, although people are at greater risk of developing heart problems if they are overweight or have obesity, once a person has developed a heart condition, those with higher BMIs appeared less likely to die than those of average weight.

Various explanations have been suggested, including the fact that once someone has developed heart problems, some extra fat is somehow protective against further health problems and death, especially as people who develop a severe and chronic illness often lose weight.

“We have known for a long time that obesity is a risk factor for cardiovascular disease, so the results of the [current] study are not surprising,” said Dr. Cheng-Han Chen, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in California.

The extra weight seems to provide a buffer for older adults.

“This study is right in line with other studies that indicate extra weight in later years can be protective of certain illnesses,” Chen, who was not involved in the research, told Medical News Today. “It is commonly observed that there is a diminishing of the risk as people get older; older people with an increased BMI tend to have better cardiovascular outcomes. This could indicate that the extra weight shows robustness. They are not frail and sickly. We aren’t sure exactly why older people with extra weight are more robust and healthier.”

“However, the study reinforces the need to develop heart-healthy lifestyles in the younger years. I talk to my patients about the American Heart Association Life’s Essential 8, which gives a roadmap to better heart health. One of those is to maintain a healthy weight and follow healthy eating principles,” Chen added.

This article originally appeared on Medical News Today.

Was this helpful?
View All Healthgrades Neurology Professionals Articles
© 2004-2022 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. See additional information.
MNT copyright image