Work

Abdominal obesity and life expectancy in adults with and without cardiovascular disease

Year: 2025

Type: article

Abstract: Introduction Life expectancy (LE) in the Netherlands has increased, but not always accompanied by good health, particularly in people with obesity. Obesity is a major risk factor for cardiovascular disease (CVD). Previous studies have explored its impact on LE and CVD, but findings are heterogeneous. We assessed the association between overweight and abdominal obesity and total LE, as well as LE with and without CVD in middle-aged and older adults. Methods We used data from the Doetinchem Cohort Study, including 2,323 participants aged 50-70 years (49% women). Weight categories were based on waist circumference (WC): healthy WC < 80cm/<94cm, overweight 80 < =WC<88 and 94 < =WC<102, and abdominal obesity > =88cm and > =102 for women and men, respectively. CVD and all-cause mortality were assessed via linkage to hospital and death registries. A multistate life table approach was used to estimate total and CVD-specific LE, using transition rates for three health states: CVD-free to CVD, CVD-free to death, and CVD to death, along with adjusted hazard ratios (HR) and WC category prevalence by sex and CVD status. Results In men, abdominal obesity was associated with reduced total LE at age 50 compared to healthy WC (difference: -0.52 years, 95% CI: -1.43, -0.04) and with more years lived with CVD (difference: 0.83 years, 95% CI: 0.49, 0.78). Men with overweight and abdominal obesity also lived longer with CVD than women with abdominal obesity. In women, abdominal obesity reduced both total LE (difference: -0.59 years, 95% CI: -0.79, 0.66), and and CVD-free LE (difference: -0.69 years; 95% CI: -1.48, -0.15), but did not increase LE with CVD (difference: 0.09 years; 95% CI: -0.05, 0.12). Conclusions Abdominal obesity reduced total LE in both sexes, but only in men it lead to more years lived with CVD. These findings underscore the importance of sex-specific cardiovascular prevention strategies to delay disease onset and promote a healthy lifespan in adults with abdominal obesity. Key messages • In both men and women, abdominal obesity was associated with reduced total and CVD-free life expectancy, while in women, no significant increase was observed in years lived with CVD. • Findings support targeted CVD prevention in overweight/obese middle-aged adults to reduce the long-term burden.

Source: European Journal of Public Health

DOI: 10.1093/eurpub/ckaf161.933