Stable Severe Obesity Tied to Increased Risk of HF, CVD and Mortality

Sarfaroj Khan 


April 20, 2021


  • The majority of adults in a UK cohort study who were overweight or obese retained their degree of overweight or obesity in the long term.

  • Individuals with stable severe obesity had an increased risk of heart failure (HF), cardiovascular disease (CVD) and mortality.

Why this matters

  • Findings highlight the negative impact on cardiovascular health as a result of failure to tackle the obesity crisis.

  • Further research is warranted to determine the effects of interventions to change body mass index (BMI) trajectories on future CVD outcomes.

Study design

  • A population-based cohort study of 264,230 overweight and obese individuals from the UK Clinical Practice Research Datalink (CPRD).

  • All patients were categorised into 4 BMI trajectory groups according to the World Health Organisation BMI classifications:

    • group 1 (overweight [BMI, 28.7 kg/m2]; n=95,944);

    • group 2 (class 1 obesity [BMI, 33.7 kg/m2]; n=104,616);

    • group 3 (class 2 obesity [BMI, 39.9 kg/m2]; n=50,866); and

    • group 4 (class 3 obesity [BMI, 49.1 kg/m2]; n=12,804).

  • Funding: None.

Key results

  • A small stable upward trajectory in BMI was observed across all 4 groups, corresponding to an overall mean BMI increase of 1.06 kg/m2 (±3.8) over 10 years.

  • Class 3 obese vs overweight individuals had an increased risk of:

    • overall CVD (adjusted HR [aHR], 1.40; 95% CI, 1.33-1.48);

    • HF (aHR, 3.26; 95% CI, 2.98-3.57);

    • all-cause mortality (aHR, 2.72; 95% CI, 2.58-2.87); and

    • CVD-related mortality (aHR, 3.31; 95% CI, 2.84-3.86).

  • Risk of peripheral vascular disease was lower in class 3 obese vs overweight individuals (aHR, 0.73; 95% CI, 0.60-0.89).


  • BMI is a surrogate measure of adiposity.


Iyen B, Weng S, Vinogradova Y, Akyea RK, Qureshi N, Kai J. Long-term body mass index changes in overweight and obese adults and the risk of heart failure, cardiovascular disease and mortality: a cohort study of over 260,000 adults in the UK. BMC Public Health. 2021;21(1):576. doi: 10.1186/s12889-021-10606-1. PMID: 33853578.  View full text 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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