As Obesity Increases, So Does Stroke Risk

Especially high rate among blacks may have genetic cause, researcher says

By Ed Edelson
HealthDay Reporter

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THURSDAY, Jan. 21 (HealthDay News) -- The more overweight you are, the more likely you are to have a stroke, a new study reports.

The study, which followed 13,549 middle-aged Americans for 19 years, looked at stroke risk associated with several measures of obesity, emphasizing body mass index (BMI), a ratio of weight and height, but also such measures as waist circumference.

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"We found that the risk of stroke was increased with each measure of obesity," said Dr. Hiroshi Yatsuya, a visiting associate professor of public health at the University of Minnesota and lead author of a report published online Jan. 21 in Stroke.

The degree of risk varied by sex and ethnic group. For example, people in the highest BMI category had a 1.43 to 2.12 times higher risk for stroke, with variations by race and sex. The risk ratios ranged from 1.65 to 3.19 when obesity was measured by waist circumference and from 1.69 to 2.55 when the ratio of waist to hip was used.

The risk was especially high for blacks, the study found. For example, the incidence of stroke was 1.2 per 1,000 person-years for white women and 4.3 per 1,000 person-years for black women. In the highest BMI category, rates ranged from 2.2 for white women to 8.0 for black men.

That higher incidence of stroke for blacks has been found in many previous studies, and it also is seen in Asians, Yatsuya said. The reason is unknown, but "there may be a genetic difference," he said.

But the increased risk linked to weight was evident in every ethnic group, the study found. Throughout, men and women in the highest obesity category had about double the risk for stroke as did those in the lowest category.

Obesity appears to act by increasing the incidence of high blood pressure and diabetes, two major risk factors for stroke and other cardiovascular problems, the study indicated. When blood pressure readings and diabetes were factored into the calculations, the association between obesity was weakened, "suggesting these major risk factors explain much of the obesity-stroke association," Yatsuya said.

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