Obesity attenuates gender differences in cardiovascular mortality

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Background: To estimate cardiovascular disease (CVD) mortality in relation to obesity and gender. Methods: Data from 11 prospective cohorts from four European countries including 23 629 men and 21 965 women, aged 24 to 99 years, with a median follow-up of 7.9 years were analyzed. Hazards ratios (HR) for CVD mortality in relation to baseline body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were estimated using Cox proportional hazards models with age as the timescale. Results: Men had higher CVD mortality than women in all four BMI categories (<25.0, 25.0-29.9, 30.0-34.9 and >= 35.0 kg/m(2)). Compared with the lowest BMI category in women, multivariable adjusted HRs (95% confidence intervals) for higher BMI categories are 1.0 (0.8-1.4), 1.6 (1.1-2.1) and 2.8 (2.0-3.8) in women and 2.8 (2.2-3.6), 3.1 (2.5-3.9), 3.8 (2.9-4.9) and 5.4 (3.8-7.7) in men, respectively. Similar findings were observed for abdominal obesity defined by WC, WHR or WHtR. The gender difference was slightly smaller in obese than in non-obese individuals; but the interaction was statistically significant only between gender and WC (p = 0.02), and WHtR (p = 0.01). None of the interaction terms was significant among non-diabetic individuals. Conclusions: Men had higher CVD mortality than women across categories of anthropometric measures of obesity. The gender difference was attenuated in obese individuals, which warrants further investigation.


  • Xin Song
  • Adam G. Tabak
  • Bjoern Zethelius
  • John S. Yudkin
  • Stefan Soederberg
  • Tiina Laatikainen
  • Coen D. A. Stehouwer
  • Rachel Dankner
  • Pekka Jousilahti
  • Altan Onat
  • Peter Nilsson
  • Ilhan Satman
  • Olga Vaccaro
  • Jaakko Tuomilehto
  • Qing Qiao
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Other Clinical Medicine


  • Obesity, Gender, Cardiovascular disease mortality
Original languageEnglish
Article number144
JournalCardiovascular Diabetology
Publication statusPublished - 2014
Publication categoryResearch

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