Obese people do have more heart attacks

An analysis supports the idea that obese people who are otherwise healthy are still at risk of heart problems down the road.

A new analysis supports the idea that obese people who are otherwise healthy are still at risk of heart problems down the road.

Contrary to previous results

Researchers who reviewed past studies found that even heavy people who didn't have high blood pressure or diabetes, for instance, had more heart attacks and strokes over time than healthy normal-weight people. That runs contrary to the results of some recent shorter-term reports, which suggested people could be obese but heart-healthy.

"It made perfect sense to say there might be a group that have extra body fat but aren't necessarily at risk," James O. Hill said. "I think what this study says is, they are. It's just that the risk may be lower (than among obese people who also have other problems) and it might take a little longer to see it."

Studies over 10 years or more

Hill, executive director of the Anschutz Health and Wellness Center at the University of Colorado in Aurora, co-wrote a commentary published with the new analysis. Canadian researchers pooled the results of eight studies that followed normal-weight, overweight and obese people over time. Some of those participants were metabolically healthy. Others had a mix of heart-related risk factors like a large waist circumference, high blood pressure, high triglycerides, low "good" cholesterol and diabetes.

The studies included just over 61,000 people. Over a period of three to 30 years, depending on the study, about 4,000 of them died or developed heart problems. At first, obese people without metabolic problems didn't seem to be any more at-risk than slimmer participants who were also metabolically healthy. Then, however, the researchers looked only at studies that followed people for 10 years or more. They found that over time, heavy but healthy people in those studies were 24 percent more likely to die, have a heart attack or stroke or develop heart failure.

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Prevention of Heart Attacks

Strict changes in diet and lifestyle can not only prevent heart attacks, but can reverse the clogging of the arteries, according to a small but pioneering study.

The study showed that a vegetarian diet, moderate exercise and an hour a day of yoga and meditation could produce a reversal of atherosclerosis, a blockage of the arteries that can lead to a heart attack, in men and women who were strict in following the daily regimen.

Experts say this is the first study to report that such blockage can be reversed without using cholesterol-lowering drugs or surgery.

The study, which was conducted by Dr. Dean Ornish, director of the Preventive Medicine Research Institute in Sausalito, Calif., was presented at the meeting of the American Heart Association in New Orleans.

This is a tremendously important study in the control of heart disease. It's the very first study indicating regression of coronary heart disease without pharmaceutical intervention. The results also suggest that the current medical guidelines for changes in the habits of people with severe heart disease do not go far enough.

Previous studies have shown that exercise and diet changes can slow the progression of heart disease, but not reverse it.

While the study did not determine what percentage of improvement could be attributed to the lifestyle changes alone, the researchers noted that stress-control methods have been shown to ease recovery from a variety of disorders, including hypertension.

But some experts are skeptical of the need for stress-management methods, which are not currently among standard recommendations for those with severe heart disease.

Some experts on cardiac rehabilitation question whether most people with heart disease could follow such strict changes in their habits.