Background: The prevalence of obesity has increased markedly over the past four decades; however, some reports suggest a recent plateau. There is little information available regarding recent changes in obesity prevalence among patients hospitalized with cardiovascular disease.
Objective: To define obesity trends among patients hospitalized with cardiovascular disease between 2002 and 2009 at an academic medical center.
Methods: This is a retrospective database analysis of patients admitted with cardiovascular diagnoses in 2002 versus 2009. Using ICD-9 codes, the study population was generated. Body mass index (BMI) was calculated by dividing weight in kilograms by height in meters squared (Quetelet index). Patients were assigned to 1 of 5 BMI categories: normal weight (BMI < 19-24.99), overweight (BMI 25-29.99), Grades I obesity (BMI 30-34.99), Grade II obesity (BMI 35-39.99), and Grade III obesity (BMI > 40). Patient demographics are compared with Student's T-tests for continuous data and chi2 tests for categorical data. Logistic regression models were developed in the overall cohort to ascertain differences in obesity grades I, II & III between the two time points with age, gender, race and primary ICD-9 code included as covariates. The logistic regression models were then repeated for each primary ICD-9 code.
Results: Patients admitted with cardiovascular diagnoses in 2002 (n = 1271) and 2009 (n = 1576) were stratified by BMI categories. Over this period of nine years, obesity prevalence increased significantly from 28.5% to 38.4% of patients. In particular, Grades II and III obesity increased markedly from 2002 to 2009 (7.6% versus 9.9%, and 2.7% versus 7.5%; unadjusted p = 0.04, p < 0.001 and adjusted p = 0.09 and p < 0.0001 respectively). Individuals with Grade III obesity had a higher incidence of arrhythmias, coronary heart disease, and valvular heart disease.
Conclusions: Grade II and III obesity has markedly increased among patients admitted to our hospital with major cardiovascular diagnoses in the period 2002 to 2009. With respect to hospitalized patients, the obesity epidemic is still on a steeply rising trajectory, especially for the extremely obese categories.