Overweight, Obesity Linked to Rising Heart Failure and Stroke in Men Under 40

Heart failure and stroke are rising among individuals below 40 years of age, according to a study published in the Journal of Internal Medicine. The researchers found links between obesity and low fitness in the late teen years and these early diagnoses.

The study evaluated data on 1,258,432 men who enlisted for military service in Sweden between 1971 and 1995, merged with data in the National Board of Health and Welfare's National Patient Register and Cause of Death Register for the period 1991-2016.

According to the researchers, the proportion of participants who were overweight at the time of enlistment—those with a body mass index (BMI) of 25 to 30—increased from 6.6% to 11.2% between 1971 and 1995, while the proportion of those who were obese, having a BMI of over 30, increased from 1.0% to 2.6%. Across this same time period, the level of fitness at the time of enlistment declined slightly.

“These factors—that is, overweight, obesity and low fitness—partly explain the large increase in heart failure we see in the study, and the rise in stroke as well,” said study first author David Åberg, MD, PhD, an associate professor at Sahlgrenska Academy, University of Gothenburg, specialist doctor at Sahlgrenska University Hospital, in a press release. “It's pleasing to see, despite rising obesity, a fairly sharp fall in heart attacks among these younger men, and also their reduced mortality from cardiovascular diseases.”

According to the study, heart-failure cases within 21 years of enlistment rose by 69%, whereas stroke cases—including cerebral infarction and cerebral hemorrhage—increased by 32%. In contrast, heart attacks within 21 years of enlistment fell by 43%.

The trends for cardiovascular diseases moving in opposite directions suggests other unknown factors are involved. For example, the researchers believe a sharp fall in smoking underlies the decline in heart attacks, but that overweight and obesity are still influential.

“We see that heart attacks would have decreased even more if it hadn't been for the rise in overweight and obesity,” Åberg said. “Our results thus provide strong support for thinking that obesity and, to some extent, low fitness by the age of 18 affect early-onset cardiovascular disease. So, at societal level, it's important to try to get more physical activity, and to have already established good eating habits by adolescence, while being less sedentary.”

REFERENCE

Heart failure and stroke rising in men under 40 [news release]. EurekAlert; April 8, 2021. Accessed April 8, 2021. https://www.eurekalert.org/pub_releases/2021-04/uog-hfa040821.php