Body weight and physical fitness in women with ischaemic heart disease: does physical fitness contribute to our understanding of the obesity paradox in women?

Abstract

Aims Body mass index (BMI) defined obesity is paradoxically associated with lower all-cause mortality in patients with known cardiovascular disease. This study aims to determine the role of physical fitness in the obesity paradox in women with ischaemic heart disease (IHD). Methods Women undergoing invasive coronary angiography with signs/symptoms of IHD in the Women’s Ischemia and Results Syndrome Evaluation (WISE) prospective cohort (enrolled 1997–2001) were analysed. This study investigated the longer-term risk of major adverse cardiovascular events (MACE) and all-cause mortality associated with BMI and physical fitness measured by Duke Activity Status Index (DASI). Overweight was defined as BMl >_25 to 30 kg/m2, obese as BMI >_30 kg/m2, unfit as DASI scores <25, equivalent to