Being overweight or obese throughout adulthood, especially during early adulthood, may lead to an increased risk of sudden cardiac death, according to a study published Nov. 25 in JACC: Clinical Electrophysiology.

Researchers led by Stephanie Chiuve, ScD, an assistant professor of medicine at Harvard Medical School, analyzed data from the Nurses’ Health study, following 72,484 healthy women from 1980 to 2012. Over the study period, researchers documented 445 cases of sudden cardiac death, 1,286 cases of fatal coronary heart disease, and 2,272 non-fatal myocardial infarction (MI). Results showed women who were overweight (body mass index [BMI] 25-30) and obese (BMI 30 or greater) were 1.5- and 2-times more likely, respectively, to experience sudden cardiac death over the next two years as compared to women with a healthy weight (BMI 21-23).

Further, women who were overweight or obese at the start of the study or obese at age 18 had an elevated risk of sudden cardiac death over the entire course of the study. Weight gain in early-to-mid adulthood was associated with a greater risk of sudden cardiac death at age 18, regardless of BMI. Women with a higher BMI were also at a greater risk of fatal coronary heart disease and non-fatal MI.

According to the researchers, their results showed that the risks from excess weight or weight gain in early adulthood are not completely erased by weight loss later in life. Additionally, nearly three-quarters of patients who suffer from sudden cardiac death are not considered high-risk by current guidelines. Moving forward, they explain that broader prevention strategies are needed to reduce the burden of sudden cardiac death.

“This study adds to a growing body of evidence that the adverse effects of obesity on cardiac rhythm, in this case, sudden death risk, begin in early adulthood,” says David J. Wilber, MD, FACC, editor-in-chief of JACC: Clinical Electrophysiology. “It underscores the need for earlier identification and treatment of high-risk individuals.” 

Keywords: Body Mass Index, Body Weight, Coronary Disease, Death, Sudden, Cardiac, Electrophysiology, Epidemiologic Studies, Myocardial Infarction, Obesity, Overweight, Weight Gain, Weight Loss

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