The role of obesity as a risk factor for cardiovascular disease (CVD) is controversial. In most analyses that estimate coronary heart disease (CHD) risk, greater adiposity as measured by body mass index (BMI) or waist girth is generally not associated with the development of CVD when traditional variables (age, sex, cholesterol, HDL cholesterol, systolic blood pressure, cigarette smoking, type 2 diabetes) are used to predict outcome. To further investigate the controversial role of obesity as a risk factor for CHD, data from 24 years of follow-up of the Framingham Offspring Study population sample were examined to estimate the effect of BMI on CHD and cerebrovascular disease risk. Wilson et al. showed that greater adiposity increased risk of CHD and cerebrovascular disease. BMI remained significantly related to the development of vascular disease outcomes even after adjusting for traditional cardiovascular risk factors. Moreover, it was estimated that a large part of the BMI “effect” appears to be mediated by traditional metabolic risk factors such as HDL cholesterol, systolic blood pressure, and type 2 diabetes.
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