Body mass index in a large cohort of patients assigned to age decades between <20 and ≥80 years: relationship with cardiovascular morbidity and medication.

objectiveThere is an ongoing debate about the relationship between obesity and morbidity in the elderly, the clinical relevance of overweight and obesity in older patients and the need or harms of treatment. The main purpose of our study was to investigate whether a higher BMI is associated with a worse cardiovascular risk in all age groups, especially in the older ones. SUBJECTS AND

designWe performed a retrospective evaluation of clinical data from 3926 patients who visited a medical outdoor center for diagnostic and/or therapeutic interventions in the period from January 1995 to July 2010. Patients were assigned to eight age groups of one decade from <20 years to ≥80 years.

resultsThe Body Mass Index (BMI) of our patients showed a continuous increase with increasing age with peak values in the age decade 61-70 years (26.29 ±4.42 kg/m2). This was paralleled by an increase in cardiovascular events and need for continuous medication, demonstrating peak values in the age decade 61-70 years (22.3% in the female and 24.7% in the male group). In all age decades up to 80 years the BMI values were higher in patients with events compared to those without it. multivariable linear regression analysis - including confounding variables (blood pressure, fasting glucose, HDL-cholesterol, triglycerides, physical activity, smoking) - revealed for all age groups a strong positive relation of BMI and a negative relation of fat free mass (FFM) to the probability for a cardiovascular event and need for medication.

conclusionIn all age groups, the percentage of cardiovascular events was directly correlated with the BMI. Having in mind the transition to an aging society, therapeutic and preventive strategies should, therefore, include weight management strategies also for the elderly.