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Journal of Cardiovascular Nursing:
doi: 10.1097/JCN.0b013e3181bdbc4c
ARTICLES: Prevention

High School Body Mass Index and Body Mass Index at Entry to a Cardiac Disease Risk Prevention Clinic and the Association to All-Cause Mortality and Coronary Heart Disease: A PreCIS Database Study

Gambino, Katherine K. MSN, CRNP; Zumpano, Julia RD; Brennan, Danielle M. MS; Hoogwerf, Byron J. MD

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Abstract

Objective: To investigate overweight/obese patients (body mass index [BMI], ≥25 kg/m2) at entry to a preventive cardiology clinic who had a high school (HS) BMI of 25 kg/m2 or greater versus those with a BMI of less than 25 kg/m2 to determine coronary heart disease (CHD) prevalence, all-cause mortality.

Methods: Patients (n = 4,597) who had a BMI of 25 kg/m2 or greater at the time of initial visit to the prevention clinic were asked to report their weight at graduation from HS. Patients with BMI of 25 kg/m2 or greater in HS (n = 1,285) were compared with patients (n = 3,312) with a BMI of less than 25 kg/m2 in HS. Prevalent CHD was assessed at entry. Patient mortality was assessed using the Social Security Death Index for a maximum of 7 years after the initial visit.

Results: Mean/median values for most CHD risk factors were higher in the group with an HS BMI of 25 kg/m2 or greater, with the exception of low-density lipoprotein level (120 vs 132 mg/dL; P < .001), Lipoprotein (a) level (16 vs 19 mg/dL; P = .003), and systolic blood pressure (126 vs 128. 3 mm Hg; P < .001). Patients with an HS BMI of 25 kg/m2 or greater had a higher mean BMI at initial visit (33.9 vs 30.1; P < .001) and hemoglobin A1c (6.8% vs 6.3%; P < .001) and glucose concentrations (93 vs 91 mg/dL; P = .004), with a lower mean high-density lipoprotein level (43.2 vs 46.5 mg/dL; P < .001) as well as greater prevalence of smoking (16.2% vs 11.4%; P < .001), diabetes mellitus (32.4% vs 21.8%; P < .001), CHD (47.1% vs 43%; P = .01), and specifically myocardial infarction (25.8% vs 21.1%; P = .001). Fibrinogen and urine albumin-to-creatinine levels were elevated. After adjusting for risk factors, an HS BMI of 25 kg/m2 or greater was associated with a 21% higher prevalence of CHD (odds ratio, 1.20; P = .027). However, an HS BMI of 25 kg/m2 or greater was not a significant predictor of 7-year mortality (hazard ratio, 1.03; P = .84).

Conclusion: Patients with an HS BMI of 25 kg/m2 or greater had more CHD risk factors compared with those with an HS BMI of less than 25 kg/m2. Prevalence of CHD was also significantly higher in this group. However, an HS BMI of 25 kg/m2 or greater was not a significant predictor of mortality.

© 2010 Lippincott Williams & Wilkins, Inc.

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