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Comment & Response
September 2018

The Obesity Paradigm and Lifetime Risk of Cardiovascular Disease—Reply

Author Affiliations
  • 1Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 2Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA Cardiol. 2018;3(9):896-897. doi:10.1001/jamacardio.2018.1840

In Reply We appreciate the thoughtful comments from Carbone et al and Doehner et al regarding our article1 examining the association of body mass index (BMI) with lifetime risk of cardiovascular disease (CVD) in a very large sample of population-based cohorts. From this life-course perspective, the association of obesity with greater longevity after development of CVD was a function of earlier age at diagnosis; individuals who are overweight and obese spend more time with a greater burden of CVD during their shorter lifespan, which is hardly a win. We observed that a normal BMI was associated with significantly lower cardiovascular morbidity and greater overall longevity, resulting in relative and absolute compression of morbidity. Individuals with normal BMI not only lived a longer life but also lived a healthier life, with more years free of cardiovascular morbidity.

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