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OBESITY AND HEART ATTACK – HOW BIG A RISK?
Our main theme is heart attack. Many but not all researchers agree with the popular view that fat people are prone to heart attack. This is evident from study of the Framingham population, referred to earlier, from some of Keys’ work in the Netherlands, and from the Society of Actuaries in the U.S.A. Overall, the risk of coronary heart disease is increased only moderately by obesity. Of a hundred people, the fattest twenty have about one and a half times the risk of the leanest twenty. The effect of having a high cholesterol level or of high blood pressure or smoking heavily is much greater than this. The chance of having a heart attack is not increased by slight obesity. One has to be 20% or more overweight before increased risk of heart attack and shortened life span occur.
Statisticians have used a mathematical device known as ‘multivariate analysis’ to find out how far the dangers of being overweight are really due to other factors. Fat people are likely to have somewhat higher blood pressure and cholesterol levels than thin people. Is the element of risk in obesity simply due to its association with these factors’? After allowing for other factors it seems that being overweight is not an important risk factor by itself.
Though this may be good mathematics, it is not good medicine. In many people who are at risk of heart attack because of a high cholesterol level, or diabetes, or high blood pressure, or a combination of these, obesity is also present. Obesity may be one of the causes of these ailments; and correction of obesity often lessens or corrects them. Hence, we are sure that avoidance of obesity (or losing weight if already obese) is important in reducing heart-attack risk.
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