Special Article Adolescent Overweight and Future Adult Coronary

Heart Disease

Kirsten Bibbins-Domingo, Ph.D., M.D., Pamela Coxson, Ph.D., Mark J. Pletcher, M.D., M.P.H., James Lightwood, Ph.D., and Lee Goldman, M.D., M.P.H.

N Engl J MedVolume 357(23):2371-2379

December 6, 2007

Study Overview

• Obesity, which is increasingly common among adolescents, is a risk factor for coronary heart disease (CHD)

• In this report, modeling the effects of overweight and obesity in adolescents on the risk of future CHD projects a substantial increase in the number of cases in the future

Projected Changes in Cardiovascular Risk Factors per 1-Point Increase in the Body-Mass Index (BMI)

Bibbins-Domingo K et al. N Engl J Med 2007;357:2371-2379

Estimated Prevalence of Cardiovascular Risk Factors among 35-Year-Old Men and Women in 2020, According to the Presence or Absence of a Projected Increase in Adult Obesity Associated

with Adolescent Overweight

Bibbins-Domingo K et al. N Engl J Med 2007;357:2371-2379

Annual Excess Coronary Heart Disease (CHD) Events from 2020 to 2035 Associated with Three Projections of Future Adult Obesity

Bibbins-Domingo K et al. N Engl J Med 2007;357:2371-2379

Prevalence of Coronary Heart Disease (CHD) Associated with Three Projections of Future Adult Obesity

Bibbins-Domingo K et al. N Engl J Med 2007;357:2371-2379

Effect of Treatment for Obesity-Related Risk Factors for Coronary Heart Disease (CHD) on Annual Excess CHD Events from 2020 to 2035 Associated with Future Adult Obesity

Bibbins-Domingo K et al. N Engl J Med 2007;357:2371-2379

Conclusion

• Although projections 25 or more years into the future are subject to innumerable uncertainties, extrapolation from current data suggests that adolescent overweight will increase rates of CHD among future young and middle-aged adults, resulting in substantial morbidity and mortality