Different age-related impacts of lean and obesity on cardiovascular prognosis in Japanese patients with cardiovascular risks: The J-HOP (Japan Morning Surge-Home Blood Pressure) Study.

The relationship between lean and cardiovascular events has been shown to vary with age, but the relationship between age-related lean and cardiovascular events in Asia has not been established. We divided patients enrolled in the J-HOP (Japan Morning Surge-Home Blood Pressure) study with one or more cardiovascular disease risks into three groups based on their body mass index (BMI): lean (BMI < 21), normal-weight (21 ≤ BMI <27), and obese (BMI ≥ 27). We stratified the risk of cardiovascular events of lean and obesity compared to normal weight into the patients < 65 years old and those aged ≥ 65 years. A total of 286 cardiovascular disease events were observed during the follow-up period (73 ± 46 months). Regarding the relationship between BMI and cardiovascular disease risk, both lean and obesity were independent prognostic factors: lean: hazard ratio (HR) 1.43, 95% confidence interval (CI): 1.02-2.01, p = .040; obesity: HR 1.55, 95%CI: 1.13-2.12, p = .006. In patients < 65 years old, the risk of cardiovascular disease of the lean patients was lower than that of the normal-weight patients (HR 0.39, 95%CI: 0.12-1.29, p = .124) and the risk of obesity patients was significantly higher (HR 1.77, 95%CI: 1.08-2.92, p = .024). In the patients aged ≥ 65 years, lean was a significant independent factor of cardiovascular events compared to normal-weight (lean: HR 1.70, 95%CI: 1.18-2.47, p = .005). In conclusion, lean was an independent predictor of cardiovascular events in patients aged ≥ 65 years.