Obesity as a risk factor for coronary events in Japanese patients with hypercholesterolemia on low-dose simvastatin therapy

Aim: we previously reported that obesity (defined as a body mass index (bmi) ≥25 kg/m2) was not an independent risk factor for coronary heart disease (chd) in hypercholesterolemic patients without a history of chd from the japan lipid intervention trial (j-lit). in this study,the obese j-lit subgroup was further analyzed to assess chd risk. methods: in the j-lit study,patients received simvastatin treatment (usually at 5 mg/day) for 6 years. a total of 38,385 patients (mean age: 57.7±7.9,12,111 men) without prior chd and/or stroke were analyzed. results: in this cohort,181 chd (acute myocardial infarction or sudden cardiac death) were observed. obesity (n 12,929) was not an independent risk factor for chd (relative risk; 1.18,95% confidence interval; 0.87-1.59) after adjustment for the major risk known factors,such as age,sex,hypertension,diabetes mellitus (dm),and smoking. however,blood pressure,triglycerides,and fasting plasma glucose all increased,while high-density lipoprotein-cholesterol decreased,with increased bmi. the percentage of patients having two or three risk factors (such as dyslipidemia,hypertension,and dm) also increased with increased bmi. conclusions: obesity was not an independent risk factor for chd in hypercholesterolemic patients on statin therapy; however,it is important to control obesity,a condition in which chd risks accumulate,in order to improve associated risk factors along with the treatment of each risk factor,thus further reducing the risk of chd.