Relation of body weight to development of coronary heart disease. The Framingham study.

Interrelationships between weight change, serum cholesterol, blood pressure levels, and the risk of developing coronary heart disease have been explored in 5,127 men and women who have been followed over 12 years for signs of initial development of coronary heart disease. Antecedent relative weight and weight gain after age 25 years proved to be strongly related to risk of angina pectoris and sudden death but were unassociated with development of myocardial infarction. An excess risk of angina pectoris and sudden death appeared to exist in obese men both with and without elevations of blood pressure and serum cholesterol, indicating an independent contribution of obesity to the rate of development of these manifestations of coronary heart disease. Unless accompanied by an increase in blood pressure and serum cholesterol level, obesity appeared to play a negligible role in women. Subjects with both these predisposing factors and obesity had a pronounced increase in risk, greater than that associated with either factor alone. The data suggest that overweight may be instrumental in bringing out symptoms of angina pectoris or in precipitating sudden death by imposing an increased workload on a heart with an already compromised coronary circulation.