Abstract 13707: Body Mass Index and Mortality in Adults With Atherosclerotic Cardiovascular Disease in the United States

Introduction:The association between body mass index (BMI) and mortality risk has been previously shown to follow a J- shaped pattern, with a greater mortality risk at the lowest and highest BMI levels. However, this association has not been fully evaluated in a population with atherosclerotic cardiovascular disease (ASCVD). We examined the BMI-mortality associations in the general population, and in a population with ASCVD.Methods:We used data from 2006-2014 National Death Index-linked National Health Interview Survey, a US nationally representative survey, for adults ≥ 18 years. Participants were classified based on self-reported ASCVD. BMI was calculated based on self-reported height and weight and was classified as normal/overweight (BMI 18.5-29.9 kg/m2), obesity class 1 (30-34.9 kg/m2), class 2 (35-39.9 kg/m2), and class 3 (≥40 kg/m2); participants who were underweight (<18.5 kg/m2) were excluded. Multivariable cox proportional hazards models were used to examine the risk of all-cause, cardiovascular, and non-cardiovascular mortality.Results:A total of 252,9568 adults, including a weighted 8.1% (or 18.6 million annually) with ASCVD, were included in the analysis. During a median follow-up of 4.5 (IQR: 2.5-6.8) years, (1179 million person-years), mortality rates, both cardiovascular and non-cardiovascular, were higher in the ASCVD group compared to the general population (Fig: panel A). In the general population, those with obesity class 3 had a higher risk of cardiovascular and non-cardiovascular mortality compared to individuals with normal/overweight, whereas individuals with obesity class 1 had a lower non-cardiovascular mortality risk. An overall similar pattern of association was observed in the ASCVD population in non-cardiovascular, but not cardiovascular, mortality (Fig: panel B).Conclusion:Greater BMI categories were associated with higher non-cardiovascular, but not cardiovascular, mortality in the ASCVD population.