02 May 2012

Relationship Found Between Body Mass Index (BMI) and risk for Ischemic Heart Disease (IHD)

Ischemic Heart Disease (IHD) is a heart disease where the heart receives a reduced blood supply (ischemia).

Technical terms define IHD as an imbalance between myocardial perfusion and myocardial demand. Myocardium is the muscular tissue of the heart. The myocardium is an active muscle and it has demands for metabolic substrate and oxygen and when there is an imbalance between the amount of blood being prefused, supplying these things to the myocardium, and the amount of blood needed in order to function, ischemia results; an inadequate blood supply results.

Risks for IHD increases with age, smoking, hypercholesterolaemia (high cholesterol levels), diabetes, and hypertension (high blood pressure), and is more common in men and those who have close relatives with ischaemic heart disease.

Symptoms for stable IHD includes angina (chest pain on exertion) and decreased tolerance for physical activities. IHD is diagnosed through an electrocardiogram, blood tests for cardiac markers, cardiac stress testing or a coronary angiogram.

Depending on the symptoms and risk, treatment may be with medication, percutaneous coronary intervention (angioplasty) or coronary artery bypass surgery (CABG).

Evidence for causal link between increased BMI and ischemic heart disease

A Mendelian randomization analysis conducted by Børge Nordestgaard of Copenhagen University Hospital, Denmark and colleagues, using data from observational studies, supports a causal relationship between body mass index (BMI) and risk for ischemic heart disease (IHD). The findings, published in this week's PLoS Medicine, have important implications for public health policy because they show that the association between BMI (which is modifiable by lifestyle changes) and IHD is continuous. This means that any increase in BMI increases the risk of IHD; there is no threshold below which a BMI increase has no effect on IDH risk.

Video: Ischemic Heart Disease (IHD)

The authors state: "This analysis demonstrates the value of observational studies and their ability to provide essentially unbiased results because of inclusion of genetic data avoiding confounding, reverse causation, and bias."


Public Library of Science
Copenhagen University Hospital
PLoS Medicine
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