'Obesity paradox' no influence on stroke risk

Obese patients do not have lower mortality rates than underweight or normal weight patients.

Obesity may not influence stroke risk in older patients
Obesity may not influence stroke risk in older patients

HealthDay News -- There is no evidence of an obesity paradox in patients with stroke, suggesting previous findings were an artifact of selection bias, according to researchers.

“Reports of an obesity paradox have led to uncertainty about secondary prevention in obese patients with stroke,” wrote Christian Dehlendorff, PhD, of the Danish Cancer Society Research Center in Copenhagen, and colleagues in JAMA Neurology.

To study the survival rates of stroke in the first week or month in relation to body mass index, researchers used data containing information on all hospital admissions for stroke in Denmark from 2003 to 2012, including 53,812 patients with BMI data.

Overall, 9.7% of patients who had experienced a stroke were underweight, 39% were of normal weight, and 34.5% were overweight and 16.8% were obese.There was no difference in the risk for death by stroke in the first month among patients who were normal weight (reference), overweight (hazard ratio, 0.96; 95% CI: 0.88-1.04), and obese (HR, 1.0; 95% CI: 0.88-1.13).

BMI was inversely related to the patient's mean age at stroke onset, indicating that strokes occurred at a younger age for patients with a higher BMI (P<0.001).

“We found no evidence of an obesity paradox in patients with stroke,” wrote the researchers. “Stroke occurred at a significantly younger age in patients with higher BMI. Hence, obese patients with stroke should continue to aim for normal weight.”

References

  1. Dehlendorff C et al. JAMA Neurology. 2014; doi: 10.1001/jamaneurol.2014.1017
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