The present study demonstrated that all the cardiac risk factors increased by an increase of BMI both in men and women and the changes were only non-significant for HDL-C reduction in men. Overweight and obesity are two of the common health problems in modern societies so that their prevalence has been increased globally.32
According to recent studies, one out of two American adults is obese or overweight. This means that their BMI is higher than 25 and in fact this statistic has increased by 5% compared with three decades ago and this obvious value increase can be seen in any age and sex.33
In addition, according to other studies, excessive weight is associated with increased cardiovascular events, type II diabetes mellitus, hypertension, stroke, dyslipidemia and also degenerative bone diseases (osteoarthritis) or increased prevalence of some cancers. 35
Therefore, in the present study, we investigated the cardiovascular events in different subcategories of the society based on age and sex and by considering different weight categories in different countries and races. For instance, in a study in Canada, it was determined that BMI in both men and women is increased with aging and simultaneously systolic and diastolic blood pressure also increased. Furthermore, in a study in Canada, different parameters of lipids increased without any correlation with sex and weight. All the mentioned results were in accordance with the present study.38
On the other hand, in a study in China, which is an Asian country similar to Iran, it was indicated that BMI changes had an inverse correlation with BMI and HDL-C; but had a direct correlation with LDL-C, Total cholesterol and TG. This was in accordance with the findings of the present study. In the study conducted in China, specifically BMI changes and mean values of cardiovascular risk factors are slightly more in men than in women.38
While such a result was not seen in the present study by reviewing the obtained results and changes figures based on metabolic risk factors. However, by comparing the China results with the results of the present study which was calculating incidence risk of cardiovascular events during the next ten years, we found similar results. However, it should be noted that diabetic patients were excluded from the present study and those were studied who had impaired FBS but had no history of diabetes and this item also increased with increased BMI. Moreover, in the study of Frank et al. about the association of diabetes mellitus with abdominal adiposity in old women, there was also a direct correlation between incidence of diabetes and increased weight which was in accordance with the present study.37
According to some studies in Iran in which overweight and obesity were considered as a unit without any classification, it was indicated that increased BMI was seen in both sexes. It was particularly observed more among young women than men.18
According to another study, there was also no overweight and obesity classification, it was indicated that changes of blood pressure, diabetes, increased total cholesterol, and TG and decreased HDL-C were significantly different for those with overweight and obesity compared with normal weight people.16
All the above items are in accordance with the present study. In addition, weight specifically increased LDL-C and we also found a similar result. In the above mentioned study, it was indicated that mean values of different blood lipids, FBS and mean blood pressure of the study subjects with normal weight was different to those with obesity and/or high weight, which was also in accordance with the present study. However, in previous studies, there was also a correlation between overweight and obesity, with hypertension and changes of blood lipids, which was in accordance with the present study.19
In the present study, although different categories of overweight and obesity were reviewed with CVD risk factors, we only considered BMI. While perhaps it would have been more appropriate if we had investigated WC, HC and WHR too. In addition, we only assessed mean years of education and their mean age and further studies are recommended to review the effect of different ages and different educational grades on weight.
According to the researchers conducted by the Third National Health and Nutrition Examination Survey (NHANES III) during 1994-1998, it was determined that the prevalence of obesity is increasing for both sexes of any age.42
Moreover, according to the studies of Siidiro Poulus et al, coronary artery diseases and different items resulted from it such as stroke or peripheral vascular injuries are specifically associated with obesity.31
In other words, according to the statements of the American Heart Association, obesity is a major and controllable risk factor for CVD so that high weight is a predicting risk factor for probable existence of atherosclerosis and can have effect on its classic risk factors.42
In fact, increased relative risk of CVD in various weight categories can particularly be seen, this was also seen in the present study.8
It has been announced that risk of fatal and nonfatal cardiovascular events in men in their middle ages will increase to 72% if their BMI is between 25 to 29 Kg/m2
. In the present study, history of diabetic diseases co morbidity with CVDs was removed. However, reviewing the figures related to the 10-year risk of cardiovascular events showed that an increased risk of CVD is associated with increased blood sugar, but this was not observed in women. However, given that the increasing prevalence of obesity and also the direct and indirect association of being overweight with many conventional cardiovascular risk factors, all the general practitioners and expert physicians should be trained about obesity, and its relevant items and risks should be identified properly and accurately. Particularly for general practitioners who have a limited and certain amount of time in frequency of examinations for each patient.