The Relationship Between Body Mass Index (BMI) and Cardiovascular Disease Risk: A Meta-Analysis

Abstract

Cardiovascular diseases (CVDs) are the leading cause of death worldwide and Body Mass Index (BMI) is a known modifiable risk factor. The association between BMI and CVD risk is well-certified yet inconsistences exist in findings across studies, which calls for a complete meta-analysis of this association. To quantify the association between BMI and cardiovascular disease risk in populations, we performed this systematic review and meta-analysis. For instance, the study aims to estimate what is the pooled effect size for BMI (underweight, normal weight, overweight, and obese) categories and the sources that originate heterogeneity, i.e., demographic variables such as age, sex or geographical location. A literature search was conducted in PubMed, Scopus and Web of Science for observational studies published between 2000 and 2023. Only cohort, case control and cross-sectional studies assessing BMI and CVD risk in human adults were included. The meta-analysis was conducted by using the random effects model and I² statistic was used to assess heterogeneity. Age, sex and geographic region were used as subgroup analyses. Cronbach alpha and the AHRQ tool were used for assessment of risk of bias using the Newcastle-Ottawa Scale. 20 studies were included in total. The pooled OR for BMI ≥25 and CVD risk was 1.52 (95% CI: 1.30-1.77), corresponding to a 52% increased risk of CVD. The associations were stronger in older adults and women. There was significant heterogeneity and sensitivity analyses confirmed robustness of the results (I² = 65%). The risk of cardiovascular disease is strongly linked to higher BMI. Interventions for weight management targeted at patients with high exposure to CVD risk are essential to offset CVD burden, including in high-risk groups.