Coronary artery disease appears early on among the obese

scaleA new study, utilizing the technology of specialized CT scanning for coronary artery calcification (CAC), found that prolonged abdominal obesity beginning in young adulthood might be responsible for an increased risk of clinical coronary artery disease (CAD).

A multicenter group of scientists led by Dr. Jared Reis of the National Heart, Lung and Blood Institute of the NIH followed over 3,200 people aged from 18-30 at the initiation of the study, over the course of 15 to 25 years. None of the group was obese at enrollment. They all had CT coronary scans at year 15, 20 and 25, while their overall and abdominal obesity scores were calculated periodically as well, based upon their BMI and waist circumference, respectively.

The findings, as published in this week s JAMA, were that overall obesity conferred an increased risk of CAC of about 2 percent for each year of obesity, while the similar risk increase for abdominal obesity was about 3 percent for each year. At the end of the study, overall rates of CAC were about 50 percent higher for those who had 20 or more years of obesity, as compared to those who remained non-obese.

The authors state that, Longer duration of overall and abdominal obesity was associated with subclinical coronary heart disease and its progression through midlife independent of the degree of adiposity. Preventing or at least delaying the onset of obesity in young adulthood may lower the risk of developing atherosclerosis through middle age.

In other words, the longer duration of exposure to excess overall fatness and, especially, abdominal adiposity,and an earlier age at onset is likely to have important impacts on the future burden of CAD and in all likelihood on the rates of clinical cardiovascular disease the number one killer in America.