thin people more likely to have heart attacks

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The study, presented recently in Atlanta at the American College of

Cardiology's Annual Scientific Session, tracked 1,231 patients who had

previously experienced

at least one bout of heart failure. It is the first to assess the relation

between BMI and the risk of sudden cardiac death.

The " Obesity Paradox " : Bigger Girth Means Lessened Risk of Cardiac Death

Totty

Apr 3, 2010

After generations of warnings that obesity is one of the biggest risk

factors for heart failure and cardiovascular disease, a University of

Rochester study

says that it's actually skinny people who run a higher risk of sudden death

from cardiac failure. Scientists at the University of Rochester Medical

Center

in New York found that non-obese patients who suffered heart failure had a

76 percent greater risk of sudden cardiac death than obese patients.

The " non-obese " category included underweight, normal weight, and

overweight-but not obese-patients, based on body mass index. The study used

the clinical

definition of obesity as a BMI of 30+. Overweight was defined as a BMI of 25

to 29, and normal and underweight were defined as 25 or below. When

overweight

patients were factored out, the researchers were startled to find that

underweight and normal-weight patients ran a 99 percent higher risk of

sudden cardiac

failure than obese patients.

The study, presented recently in Atlanta at the American College of

Cardiology's Annual Scientific Session, is the first to assess the relation

between

BMI and the risk of sudden cardiac death.

Researchers tracked 1,231 patients who had previously experienced at least

one bout of heart failure. Some of them later became obese, a condition that

would seemingly increase their chance of subsequent heart failure. The study

findings showed, however, that a lower BMI was more closely associated with

an increased risk of sudden cardiac death than an increased BMI.

These findings, though perhaps surprising to the general public, hew closely

to something that cardiologists have known about for some time: the " obesity

paradox, " in which obese patients stand a better chance of avoiding death

from heart failure than their thinner counterparts.

So the question for researchers is why obese people, who for years have been

considered at very high risk for stroke or heart attack, seem to enjoy a

greater

immunity to heart failure than people whose weight puts less strain on their

cardiovascular systems?

One tentative answer offered by researchers, who acknowledge that a

definitive answer will require more study, is simple genetics. Hansen,

co-lead

author of the study and a second year medical student at the University of

Rochester, said that there may be a genetic reason, noting that obese

patients

generally do not eat well or

exercise

properly, and that many smoke. He theorizes that because their bodies are

already surviving bad treatment, they are more resistant to heart failure.

Sudden cardiac death is a condition in which the heart suddenly stops

beating. Unless the heart is restarted and the circulation of oxygen

throughout the

body is restored within minutes, the victim dies. An estimated 330,000

Americans die from the condition each year-about half of all heart-related

fatalities.

Cardiac arrest is attributed to abnormal heart rhythms that can be brought

on scarring from previous heart attacks or arterial blockage. In a related

study,

the University of Rochester researchers looked into the effects of BMI on

the effectiveness of implantable cardioverter defibrillators. An ICD is a

small

pager-sized unit that is surgically implanted in the chest to detect

irregular heart beats. When it detects a faulty rhythm, the device can send

a shock

to the heart to make it return to normal. The researchers found that ICDs

were most effective in people with lower BMIs.

* * *

Source:

As girth grows, risk of sudden cardiac death shrinks

http://www.urmc.rochester.edu/news/story/index.cfm?id=2791

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Categories:

Health Research,

Heart Care & Heart Disease,

Pre-Diabetes

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