Cardiovascular events in patients with obesity: an observational study.

BACKGROUND Overweight and obesity are positively correlated with increased risk of morbidity and mortality. AIM To evaluate whether obesity may be considered an independent cardiovascular risk factor in patients of ages from 35 to 74 years followed-up for 10 years. DESIGN OF STUDY Observational, longitudinal retrospective study. SETTING Primary care practices in Badajoz (Spain). METHOD A cohort of 899 patients (mean 55.7 years; 58.2% female) without evidence of cardiovascular disease was studied. RESULTS A total of 33.5% of the population were obese (body mass index > or =30 kg/m2). Patients meeting the obesity criteria were more commonly female (36.6%) and were older, had higher mean values of blood pressure and triglycerides, higher percentages of diabetes, and higher coronary risk using either the original Framingham or the Framingham function calibrated for the Spanish population (Framingham-REGICOR). During the follow-up period, the rates of cardiovascular events and death in patients with obesity tended to be higher: 16.3% versus 11.7%, P = 0.056 and 4.7% versus 2.2%, P<0.05, respectively. In the final model of the logistic regression multivariate analysis, the significant predictors of cardiovascular events in patients with obesity were age, sex (male), diastolic blood pressure, diabetes, and smoking. The highest odds ratio corresponded to smoking (odds ratio 2.03; 95% confidence interval = 1.22 to 3.38). CONCLUSION Obesity may not be considered an independent cardiovascular risk factor in patients aged from 35 to 74 years followed-up for 10 years.